The results showed that, in general, clients were more satisfied with health services than treatment services (medicine, dentistry, pharmacy, injection, and laboratory). The reasons for dissatisfaction with dentistry were inadequate services; with medicine, lack of experience in physicians and absence of various specialties; with pharmacy, lack of needed drugs prescribed by physicians of the centers; with injection, presence of some male personnel for female patients; and with laboratory, lack of this service in all centers and the resulting inability to perform all diagnostic tests and wastage of much time. The reasons for dissatisfaction especially in vaccination and family planning departments included time wastage, too long waiting, insufficient working hours and lack of attention to patients without any health education. All of the above can create pessimism toward healthcare delivered by professionals.
Finally, the results showed that, according to the clients, general satisfaction resulted from appropriateness of facilities, availability of the centers for distance, cheap and free medical services, endeavor of employees as far as possible, and delivery of suitable services by some healthcare workers or physicians of the centers. However, despite the satisfaction expressed by clients, there is an urgent need to study about the quantity and quality of services in healthcare centers affiliated to the university to promote the present situation and to make clients come to the centers not only for the above reasons. This reveals the importance of improving managerial indicators in these centers more.
By being qualitative and having detailed interviews about the problems of urban health care centers, this study is the first one of its type and can pave the way of future studies in this field and in making required tools for assessing satisfaction in such clients. Suggestions based on research findings include:
1- Informing clients about their rights by posters and pamphlets prepared by health centers or mass media is essential because knowing these rights makes people familiar with their expectations and demands and while improving the quality of services, provides the opportunity for clients to offer better suggestions.
2- Informing society about healthcare system, its ranking, and job description of employees in each rank, … is vital to enable people to make their demands compatible with this structure (with respect to suggestion of clients to be provided with the services of specialists in urban health centers, the first rank, which shows the lack of knowledge in people about the services that should be delivered in this rank).
3- Holding periodic or monthly illuminative sessions by provincial healthcare centers for all types of employees in healthcare centers concerning “communication and the quality of service delivery” is crucial to solve present problems and provide solutions by employees themselves for increasing cooperation.
4- Holding weekly or even daily sessions for employees in urban healthcare centers for exchanging views and new information or stating current problems and trying to solve them in time is very important, which can be so effective in improving service delivery by the employees especially if it is supported by officials.
5- Encouraging employees in a proper manner to motivate active and responsible people more and, therefore, increase clients’ satisfaction would be very effective.
We would like to express our gratitude to respectful deputy of research in Shaheed Beheshti University of Medical Sciences, Dr. Jorjani, and to all respectful officials of Shemiranat, North, and East healthcare centers as well as clients for their sincere cooperation.
|Age||Less than 25 years||20-25 years||25-30 years||30-35 years||35-40 years||40-45 years||More than 45||Total|
|Level of education||Uneducated||Primary||Guidance||High school||High school graduate||Diploma||Bs||Student||Dr||No response||Total|
|Number of kids||No kids||1 kids||2 kids||3 kids||4 kids||5 kids||More than 6 kids||No response||Total|
|Number of visits||1-3 years||3-5 years||5-7 years||7-9 years||9-11 years||11-13 years||13-15 years||More than 15 years||Total|
|Reason of visits||Medicine||Dentistry||Women health||Maternity & child health||vaccination||Lab||Pharmacy||Injection||Family planning||Total|
1,2: Faculty members in Shaheed Beheshti University of Medical Science and Health Services . School of Nursing and Midwifery