Quality perception in health care: A qualitative study

The aim of the research is to determine the elements that constitute the service quality in health institutions in line with the interviews with service users. With a common view, quality is defined as "conformity to customer demands and needs" and it is clear that only the elements that make up the quality can be fully determined by the customers in line with this definition. In this direction, it was tried to determine what is taken into consideration in health service quality with the data obtained from people who directly evaluate the service. In the study, it is aimed to determine the elements that make up the quality of health care services directly from the statements of the people who receive health services. In this context, in-depth interview method, which is a qualitative analysis technique, was used and semi-structured interview questions were used. Interview data were classified taking into account the service quality dimensions existing in the literature. In the classification made, in addition to the five dimensions of the ServQual scale, which are widely used in evaluating the service quality, the "information" dimension and "technical service quality" were evaluated. Interviews were held with 93 people in Samsun and Sinop provinces, and the interviewees were randomly selected from among the people living in this province. The expressions expressed in the interviews were tried to be classified under the most appropriate quality dimension. All statements could be classified under the dimensions of technical service quality, concrete elements, reliability, sensitivity, assurance, empathy and informing. It is seen that the existing quality dimensions have an important explanatory effect in determining the service quality in that all statements can be classified under existing dimensions. However, when the expressions of the ServQual scale are compared with the statements of the participants, it is seen that they are insufficient in terms of evaluating the quality of health services. One of the most important difficulties in evaluating service quality is the impact of the participants on the process and therefore on quality. The number and behavior of other participants in the service process has an impact on all quality dimensions. The relationship between quality dimensions makes it more difficult to evaluate. In addition, the fact that the participant expressions cover different dimensions at the same time makes it difficult to classify. Hygiene, timing, the numerical and diverse adequacy of staff and tools are the factors that are mentioned by most of the participants and affect all other quality dimensions. At the end of the research, it was determined that the perception of service quality can be measured through the quality dimensions that increase the efficiency of the service, that the customers attach importance to the quality dimensions, the most important quality dimension that affects their expectations is reliability, and the least affecting dimension is information. It has been observed that the patients' perception of service quality directly affects their preference of the same hospital and recommending it to their environment.