Quality of Health Services and the Factors Affecting it: A Cross-Sectional Study in Pilot Hospitals for Electronic Referral System

Background and objectives Health system services are not reliable without quality assessment. It is important to explore gaps between standard services and existing situation to improve the quality of health system. His study aimed at studding the quality assessment of electronic referral system in one of the major provinces of Iran. Material and Methods This study was a cross-sectional study utilizing SERVQUAL model. The population comprised 3 groups totaling approximately 11,004 people. The sample size allocated to each city was determined in view of the ratio of patients. A sample of 384 patients who used electronic referral service at level 2 and revived outpatient services constructed the population of study. The data were collected through a two-part questionnaire. The validity of the questionnaire was confirmed by 10 experts including senior and mid-level managers and medical science university faculty members. The questionnaire assessed demographic data and the patients' perceptions and expectations. Data was analyzed using descriptive statistics and analytical statistics such as nonparametric mean comparison tests, in view of the normality assumption,) including Wilcoxon test, Mann-Whitney and Kruskal-Wallis. Spearman correlation test was used to determine the intensity of correlation between the study variables. The significance level of all tests was considered 0.05. Results There were identified gaps throughout all dimensions of health service among the studied clinics (P