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Rehabilitation Practice and Science

Translated Title

運用PZB模式評估偏鄉公立地區醫院復健醫療服務品質

Abstract

Background: Previous studies on rehabilitation have rarely focused on the medical service quality. Not to mention studies about the medical service quality of rehabilitation in the rural public hospital. The expectations and needs of the patients and their caregivers should be emphasized. We applied the concept of Parsuraman,-Zeithaml,-Berry (PZB) service quality gap model and expected zone of tolerance to determine the difference in the medical service quality between the expectations and satisfaction of patients and their caregivers who received rehabilitation in a rural local public hospital in southern Taiwan. Methods: We used a 30-item structured questionnaire, modified from the 22- item SERVQUAL instrument, with high validity and reliability that compromised five dimensions: (1) tangibles, (2) reliability, (3) responsiveness, (4) assurance, and (5) empathy. The questionnaire was given randomly to two groups from July to September in 2020 at the rehabilitation department of Ci-Shan hospital. Group one was the patients or their caregivers who received regular rehabilitation at the target hospital for at least 1 month. Group 2 was therapists who provided regular medical service in the rehabilitation department for at least 1 month. The paired t- test was used to analyze the gap in service quality between the expectation and satisfaction scores of the two groups. The independent t-test was used to compare the expectation and satisfaction scores between the two groups. Results: A total of 99 patients (or their caregivers) and 27 therapists were enrolled in this study. The effective response rate was 97.2 %. The content validity index was 0.94, and the Cronbach's alpha for internal reliability was 0.854-0.929. Intragoup analysis found only significant differences between the expectation and the satisfaction scores in the tangible aspect in the group 1 and in the tangible and the assurance in the group 2. Intergroup analysis observed several significant differences in both the expectation and the satisfaction scores between the group 1 and the group 2. Meanwhile, all the scores of these significant items were lower in the group 2. The service quality gap in the scores of the patients' parents was influenced by traits, such as age and education level. The patients' parents focused more on the cleanliness of the therapeutic environment, rehabilitation in sessions being completed on schedule, therapists possessing sufficient expertise, and accommodations of the individualized needs of patients. In addition, the study showed aspects requiring urgent improvements in our hospital, including procuring additional therapy equipment, maintaining clean environment, and scheduling individualized rehabilitation times. Conclusion: Our study observed that the medical service quality gap in the scores of the patients and their caregivers presented in only the tangible aspect, which meant that the rehabilitation we currently provided could meet their expectations except for the hardware. To enhance the medical service quality, we need to improve the environment and equipment of in the rehabilitation department in the near future. Applying the PZB model may offer a method for evaluating health care service quality in rehabilitation field.

Language

Traditional Chinese

First Page

73

Last Page

89

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