Volume 16, Issue 5 (Sep & Oct 2026)
J Research Health 2026, 16(5): 479-486 |
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Ethics code: IR.MUMS.FHMPM.REC.1401.058
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Mousaei I, Moradi A, Mosa Farkhani E, Satarzadeh L, Asif Kabir M, Vafaee Najar A. Enhancing Hospital Service Quality in Afghanistan: A Patient-centered SERVQUAL Evaluation. J Research Health 2026; 16 (5) :479-486
URL: http://jrh.gmu.ac.ir/article-1-2802-en.html
URL: http://jrh.gmu.ac.ir/article-1-2802-en.html
Iman Mousaei1 
, Amin Moradi1 , Ehsan Mosa Farkhani1 , Laleh Satarzadeh2 , Mohammad Asif Kabir2 , Ali Vafaee Najar3
, Amin Moradi1 , Ehsan Mosa Farkhani1 , Laleh Satarzadeh2 , Mohammad Asif Kabir2 , Ali Vafaee Najar3
1- Department of Epidemiology, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
2- Department of Health Economic and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Department of Health Economic and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. ,vafaeea@mums.ac.ir
2- Department of Health Economic and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran.
3- Department of Health Economic and Management Sciences, School of Health, Mashhad University of Medical Sciences, Mashhad, Iran. ,
Abstract: (736 Views)
Background: This study aimed to determine gaps between patient expectations and perceptions of healthcare services in hospitals in Herat City, Afghanistan, using the SERVQUAL model.
Methods: This cross-sectional study was conducted among inpatients at public and private hospitals in Herat City, from July to December 2022. The study population included hospitalized Afghan patients who could communicate in Dari Persian. A sample size of 337 patients was calculated based on previous satisfaction rates. Participants were selected through simple random sampling from various hospital departments. The validated Dari Persian version of the 22-item SERVQUAL questionnaire was used to collect data on patient expectations and perceptions across five service quality areas (tangibles, reliability, responsiveness, assurance, and empathy) on a 5-point Likert scale. Descriptive statistics were determined, and paired t-tests were conducted to compare expectation-perception gaps across SERVQUAL dimensions.
Results: Analysis of SERVQUAL scores revealed no significant differences between patients’ expectations and perceptions across all five service quality dimensions (P>0.05, paired t-test), indicating close alignment. The mean differences (gaps) were minimal, with the largest in reliability (-0.14) and responsiveness (-0.09), followed by tangibility (0.09), assurance (-0.01), and empathy (-0.01). The overall SERVQUAL gap score was -0.03, suggesting that expectations were generally met with subtle variations in tangible and reliability aspects such as facilities and dependability.
Conclusion: No statistically significant quality gaps were found across all service dimensions in Herat hospitals. However, small negative gaps in reliability and responsiveness suggest minor opportunities for improvement, particularly in dependability and prompt service. Targeted, patient-centric efforts are recommended to further enhance service quality, with particular attention to vulnerable patient subgroups.
Methods: This cross-sectional study was conducted among inpatients at public and private hospitals in Herat City, from July to December 2022. The study population included hospitalized Afghan patients who could communicate in Dari Persian. A sample size of 337 patients was calculated based on previous satisfaction rates. Participants were selected through simple random sampling from various hospital departments. The validated Dari Persian version of the 22-item SERVQUAL questionnaire was used to collect data on patient expectations and perceptions across five service quality areas (tangibles, reliability, responsiveness, assurance, and empathy) on a 5-point Likert scale. Descriptive statistics were determined, and paired t-tests were conducted to compare expectation-perception gaps across SERVQUAL dimensions.
Results: Analysis of SERVQUAL scores revealed no significant differences between patients’ expectations and perceptions across all five service quality dimensions (P>0.05, paired t-test), indicating close alignment. The mean differences (gaps) were minimal, with the largest in reliability (-0.14) and responsiveness (-0.09), followed by tangibility (0.09), assurance (-0.01), and empathy (-0.01). The overall SERVQUAL gap score was -0.03, suggesting that expectations were generally met with subtle variations in tangible and reliability aspects such as facilities and dependability.
Conclusion: No statistically significant quality gaps were found across all service dimensions in Herat hospitals. However, small negative gaps in reliability and responsiveness suggest minor opportunities for improvement, particularly in dependability and prompt service. Targeted, patient-centric efforts are recommended to further enhance service quality, with particular attention to vulnerable patient subgroups.
Type of Study: Orginal Article |
Subject:
● Service Quality
Received: 2025/05/12 | Accepted: 2025/12/13 | Published: 2026/08/23
Received: 2025/05/12 | Accepted: 2025/12/13 | Published: 2026/08/23
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