title: Measuring the quality of provided services for patients with chronic kidney disease.
abstract: BACKGROUND
  The healthcare organizations need to develop and implement quality improvement plans for their survival and success. Measuring quality in the healthcare competitive environment is an undeniable necessity for these organizations and will lead to improved patient satisfaction.
  
  
  OBJECTIVE
  This study aimed to measure the quality of provided services for patients with chronic kidney disease in Kerman in 2014.
  
  
  METHODS
  This cross-sectional, descriptive-analytic study was performed from 23 January 2014 to 14 February 2014 in four hemodialysis centers in Kerman. All of the patients on chronic hemodialysis (n = 195) who were referred to these four centers were selected and studied using census method. The required data were collected using the SERVQUAL questionnaire, consisting of two parts: questions related to the patients' demographic characteristics, and 28 items to measure the patients' expectations and perceptions of the five dimensions of service quality, including tangibility, reliability, responsiveness, assurance, and empathy. The collected data were analyzed using SPSS 21.0 through some statistical tests, including independent-samples t test, one-way ANOVA, and paired-samples t test.
  
  
  RESULTS
  The results showed that the means of patients' expectations were more than their perceptions of the quality of provided services in all dimensions, which indicated that there were gaps in all dimensions. The highest and lowest means of negative gaps were related to empathy (-0.52 ± 0.48) and tangibility (-0.29 ± 0.51). In addition, among the studied patients' demographic characteristics and the five dimensions of service quality, only the difference between the patients' income levels and the gap in assurance were statistically significant (P < 0.001).
  
  
  CONCLUSIONS
  Overall, the results of the present study showed that the expectations of patients on hemodialysis were more than their perceptions of provided services. The healthcare providers and employees should pay more attention to the patients' opinions and comments and use their feedback to solve the workplace problems and improve the quality of provided services. In addition, training the health staff to meet the patients' emotional needs and expectations is suggested.
authors.affiliation: Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammadkarim
authors.initials: M
authors.lastname: Bahadori
authors.affiliation: Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, IR Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Raadabadi
authors.affiliation: School of Management and Medical Information, Kerman University of Medical Sciences, Kerman, IR Iran.
authors.forename: Majid
authors.initials: M
authors.lastname: Heidari Jamebozorgi
authors.affiliation: Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mahmood
authors.initials: M
authors.lastname: Salesi
authors.affiliation: Department of Health Services Management, School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Ravangard
keywords: Chronic Kidney Disease; Healthcare Quality Assessment; SERVQUAL