Evaluation of Health Service Quality and Efficiency in Sub-District Health Promoting Hospitals Post-Transfer to Provincial Administrative Organizations
Keywords:
sub-district health promoting hospital transfer, health service quality, efficiency, nursing competencyAbstract
This mixed-methods study aimed to evaluate the quality and efficiency of healthcare services in sub-district health promoting hospitals (SHPHs) after their transfer to Provincial Administrative Organizations (PAOs). Qualitative data were collected through in-depth interviews with 56 registered nurses as key informants from four provinces, while quantitative data were obtained from 400 service users across 10 provinces using a structured questionnaire based on the SERVQUAL framework. Content analysis was applied for qualitative data and descriptive statistics with t-tests were used for quantitative analysis. The qualitative results indicated that service continuity in basic, chronic, and emergency care was maintained post-transfer, despite increased administrative burdens and coordination gaps among staff. Quantitative findings revealed that public expectations significantly exceeded actual perceptions across all service dimensions (p < 0.05), with the largest gaps in tangible resources. Overall, service users remained satisfied with healthcare services but expressed higher expectations for further quality improvements.
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