Quality of healthcare services among adult outpatients at two Public Hospitals in East Ethiopia: Using service quality (SERVQUAL) assessment model

Abstract Background Quality of healthcare has a paramount importance for efficacious, effective and efficient healthcare services as per clinical guidelines and standards to meet or exceed patients’ expectations. The available limited evidences indicated that the quality of healthcare services in public healthcare institutions is currently questionable. Thus, this study aims to determine the expected and perceived quality of services, and identify the factors associated with perceived quality of health care services at Public Hospitals in East Ethiopia. Methods A facility-based cross-sectional study was conducted among adult outpatients in Public Hospitals from 01 March to 01 April 2021. Systematic random sampling technique was used to select the participants about perceived and expected quality of health care services. Binary logistic regression model was also fitted to identify factors associated with the perceived quality of healthcare services. Adjusted odds ratio with 95% confidence interval and P value < 0.05 were used to identify the factors associated with perceived quality of health services. Results Overall, 80% (95% CI: 77.4–85.1) adult outpatients were received good quality of healthcare services whereas, weighted service quality gap score was 86.61%. The scores for tangibility, reliability, responsiveness, assurance, and empathy were 11.60, 22.61, 21.78, 10.08 and 20.34%, respectively. Waiting time (AOR = 5.27; 95% CI: 2.45–11.31), received all laboratory tests (AOR = 2.62; 95% CI: 1.41–4.86), ultrasound service order (AOR = 2.01, 95% CI: 1.08–3.75), advise on drugs’; dose (AOR = 4.63; 95% CI: 1.29–16.68), contraindication (AOR = 2.09; 95% CI: 1.08–4.05), side effects (AOR = 2.79; 95% CI: 1.13–6.89) were the factors significantly associated with perceived quality of healthcare services. Conclusion In this study, the overall weighted SERVQUAL gap score was high with low perceived quality of healthcare services compared with patient’s expectation. Weighted SERVQUAL score was also significantly high for reliability and low for assurance dimensions. As part of improving patients' perceptions of quality health care, it is important to have, reducing waiting time, good patient-physician communication when prescribing drugs. Moreover, it could be important to have regular feedback from patients, either to the hospital or to the health professionals.