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Satisfaction with Service Delivery in Clients Referring to Urban Health Centers Affiliated to Shaheed Beheshti University of Medical Sciences and Health Services: A Qualitative Study

Dr Yaghmayie, F., Dr Mahfoozpour, S.

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Background and Purpose: Delivery of health services should be based on the needs and demands of each population. This can solve health problems and, finally, lead to clients’ satisfaction. This qualitative study was conducted to assess satisfaction with service delivery in clients referring to urban health centers affiliated to Shaheed Beheshti University of Medical Sciences and Health Services.

Materials and Methods: With respect to research aims, distribution of centers with various locations, different socioeconomic conditions of the subjects and various delivered services, 233 clients were selected by purposive sampling method from 21 urban health centers affiliated to Shemiranat, North, and East health centers supervised by the university in Tehran.

Data were collected by semi-structured interviews and the voice of the subjects was recorded with their permission by the researchers. Questions were divided into two sections: demographics in the first part and information concerning research aims including physical environment, personnel communication and service delivery of the centers in the second part. Data were analyzed by frequent listening to statements of the subjects and verbatim transcribing as well as storing them in the computer.

Results: Findings showed that the majority of subjects were satisfied with physical environment of the centers while having some critiques about other aspects. With respect to clients’ satisfaction with personnel communication, most of them were satisfied while some of them expressed their nuisance from certain behaviors of personnel. Regarding clients’ satisfaction with service delivery, most of them expressed their moderate satisfaction with some delivered services.

Conclusion and Recommendations: As a whole, findings indicated a general dissatisfaction with service delivery, time wastage, too-long waiting, inadequate period of activity as well as attention to clients, and insufficient health education. Further studies concerning the quantity and quality of services delivered by the health centers are warranted.

Key words: Clients’ satisfaction, Service delivery, Urban health centers


Since the General Assembly of the UN in 1948, healthcare has been recognized as a right with respect to Universal Declaration of Human Rights. This right was subsequently included in the Declaration of Patient Rights. In fact, evidence increasingly shows that having alternatives in different health programs for individuals’ plays an important role in their satisfaction and dissatisfaction with healthcare. Surprisingly, studies show that about %44-%58 of American employees have no rights in choosing health plans. A national survey for determining the influences of selection right in the US on 1204 randomly-selected employees less than 65 years of age showed that %42 of respondents had no right to choose their health programs and the less they had the right of selection, the more their dissatisfaction with these programs and healthcare was. It was emphasized that those subjects who had selected certain programs because of their cheapness were dissatisfied due to the limitation of delivered services (1).

Currently, the quantity and quality of health service delivery should be based on clients’ needs and demands. Promoting service delivery irrespective of people’s opinion would be inappropriate and occasionally impossible. Bond (1992) believed that health institutions should respect clients’ needs, wishes, desires and opinions. Attending to evaluation of health service delivery by clients can lead to correction of deficiencies and their final satisfaction with services of health institutes (2). Increasing clients’ satisfaction with the quality of health services results in greater productivity and benefit in health organizations (3). Some scholars believe that opinions and behavioral patterns of people should be determined prior to healthcare planning (4). Regarding the lack of attention to clients’ views, Thomson and Koh (1994) held that dissatisfaction results from inappropriate response to clients’ needs. This can lead to frustration, hopelessness, anger, permanent anxiety as well as abnormal and sometimes ill behaviors in the clients. All these problems can be projected to families, relatives, and friends by the clients with final pessimism about the care delivered by health professionals (5).

Lofferrie (1996) argued that clients satisfaction reflects the quality of services provided and its assessment as an important indicator in evaluating outcomes is a method in determining clients’ views about the condition of services (6). In addition, assessing and identifying clients’ satisfaction is a basis to develop service delivery, which, in turn, can reinforce their satisfaction. Since there is no accurate information about clients’ opinions regarding healthcare provision nationwide, the researchers decided to conduct this study to find specific results regarding clients’ satisfaction, which can then be used for better health planning.

Faculty members in *Shaheed Beheshti University of Medical Science and Health Services* . School of Nursing and Midwifery

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