Providing a Framework for Evaluating the Quality of Health Care Services Using the HealthQual Model and Multi-Attribute Decision-Making Under Imperfect Knowledge of Data

Abstract

Due to the increasing importance of evaluating the quality of health care services using the patient-centred approach, this study aimed to propose a novel framework by combining the SERVQUAL model and multi-attribute decision-making (MADM) methods using interval-valued triangular fuzzy numbers (IVTFN). In this study, after an initial overview of related work and expert opinions, a list of the most important dimensions and indicators for measuring the quality of health care services was extracted and localized. Then, to determine the importance of each of the identified factors, one of MADM’s acceptable methods called step-wise weight assessment ratio analysis (SWARA) was used. Then, in order to use the developed framework for comparing different health centres and ranking them, after collecting evaluation data in the form of linguistic variables, another practical method in the field of MADM has been used, namely, Additive Ratio Assessment (ARAS) method. The dimensions and sub-dimensions identified are, on the one hand, appropriate to the conditions of the case study and, on the other hand, the findings from the implementation show that among the dimensions of health service quality, responsiveness and then reliability has the highest rank in this case. Also, the use of IVTFN, on the one hand, eliminates the problems related to the use of Likert scale in other quality assessment methods and, on the other hand, reduces the possibility of facing imperfect knowledge of data which is a common problem in the field of qualitative evaluations. Utilizing the results of this study can significantly help decision makers in their choice of strategies to improve service quality. Furthermore, improving the quality of services can play an important role in promoting the competitiveness and performance of health care providers by increasing patient satisfaction with the services received. Also, as a side effect, the developed framework can be used to compare the performance of different hospitals and health centres, as well as their ranking.