title: Factors contributing towards patient's choice of a hospital clinic from the patients' and managers' perspective.
abstract: BACKGROUND
  Given the competitive nature of the health market and the multiplicity of factors that may contribute towards patient's choices of a hospital, patients' needs and preferences for a hospital must be considered in the planning and decision making of hospitals and health care organizations. This study aimed to identify the factors that contribute to patient's choices of a clinic and the importance of each factor.
  
  
  METHODS
  A mixed-method approach was used to collect quantitative and qualitative data in two phases. The study was conducted in a hospital clinic in 2014. Qualitative data were collected by face-to-face semi-structured interviews of a sample of 22 managers and heads of outpatient wards. The self-administered questionnaire designed for this study collected quantitative data from a stratified random sample of 381 patients referred to this clinic. The qualitative data were analyzed by a system of coding, while parametrical statistical analyses were conducted to analyze the quantitative data using the independent-samples t-test and ANOVA in SPSS software, version 21.0.
  
  
  RESULTS
  The qualitative data indicated that there were 21 factors that may contribute to patient's choices of a clinic, and these factors were classified into six categories, i.e., facilities and physical assets, physicians and employees, location and place, services, price, and promotion. Among the 16 questions studied in the quantitative questionnaire, the highest and lowest means were related to "appropriate clinic environment" (2.47 ± 0.58) and "advertising through TV and radio, the Internet, newspapers, etc." (1.77 ± 0.75), respectively. There were significant associations between "having experienced and responsive personnel, including physicians and employees" and the patient's gender and frequency of referrals, between "belonging to the Armed Forces" and the patient's age and frequency of referrals, between "advertising through TV and radio, the Internet, newspapers, etc." and shifts and frequency of referrals, between "inadequate facilities and poor quality of services provided in other health care organizations of the Armed Forces" and "adornment and good behavior of staff" and shifts (p < 0.05).
  
  
  CONCLUSIONS
  The most significant contributing factors to attract patients were the "physicians and employees," and "the clinic's environment." Therefore, it is essential for clinic managers and heads of outpatient wards to focus on and strengthen these two factors. Also, since the means of the factors were better in the morning shift, the employees should perform their duties properly and consistently in all shifts.
authors.affiliation: Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammadkarim
authors.initials: M
authors.lastname: Bahadori
authors.affiliation: Health Management Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Ehsan
authors.initials: E
authors.lastname: Teymourzadeh
authors.affiliation: School of Management and Medical Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Ravangard
authors.affiliation: School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Nasiri
authors.affiliation: Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
authors.forename: Mehdi
authors.initials: M
authors.lastname: Raadabadi
authors.affiliation: Department of Health Services Management, Tehran North Branch, Islamic Azad University, Tehran, Iran.
authors.forename: Khalil
authors.initials: K
authors.lastname: Alimohammadzadeh
keywords: choice; clinic; factors; military; patient