Hospital
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Medical Sciences
http://jhosp.tums.ac.ir
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2008-1928
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2020
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ارزیابی کیفیت خدمات بیمارستان از دیدگاه همراه بیمار با استفاده از روش FAHP و GRA-TOPSIS
یک مطالعه مقطعی در بیمارستان های منتخب شهر مشهد
Evaluation and ranking of selected hospitals in Mashhad in terms of quality of services provided by the method of FAHP and GRA-TOPSIS
سایر
سایر
مقاله ی اصیل
Original Article
<strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;">زمینه و هدف:</span></span></strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> ارزشیابی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">ارتقا</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">کیفیت</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">خدمات</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">بیمارستان­ها</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">که</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">با</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">سلامتی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">انسانها</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">سروکار دارند،</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">اهمیت</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">زیادی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">دارد</span></span><span dir="LTR">.</span><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> پژوهش</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">حاضر</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">با هدف شناسایی و وزن­دهی معیارهای سنجش کیفیت و رتبه­بندی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">بیمارستان­های</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">مشهد انجام شده­است</span></span><span dir="LTR">.</span><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> </span></span><br>
<strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;">مواد و روش­ها:</span></span></strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> پژوهش</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">حاضر</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">نوع</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">مطالعات</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">کاربردی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">است</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">که</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">صورت</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">مقطعی در زمستان سال 1396 انجام شد. در این مطالعه با</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">بررسی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">ادبیات</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">پژوهش،</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">ابعاد</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">کیفیت</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">خدمات</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">در بیمارستان</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">شناسایی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">شد.</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">سپس</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">با</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">استفاده</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">پرسشنامه مقایسه</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">زوجی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">گروه خبرگان</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">(شامل</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">8 نفر</span></span><span dir="LTR">(</span><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> نظرخواهی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">به</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">عمل</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">آمد</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">و</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">ضرایب</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">اهمیت</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">هر</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">یک</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">ابعاد</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">از</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">طریق</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">فرایند</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">تحلیل</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">سلسله</span></span><span dir="LTR">­</span><span style="font-family:B Roya;"><span style="font-size:11.5pt;">مراتبی</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">محیط</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">فازی (</span></span><strong><span dir="LTR">FAHP</span></strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;">) محاسبه شد. پرسشنامه ماتریس تصمیم</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">به روش نمونه­گیری دردسترس توسط نمونه 400 نفره از همراهان بیمار چهار بیمارستان تکمیل گردید. سپس با استفاده از روش </span></span><strong><span dir="LTR">GRA-TOPSIS</span></strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> بیمارستانها رتبه­بندی شدند. روایی هر دو پرسشنامه توسط خبرگان تایید شد.</span></span><br>
<strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;">نتایج:</span></span></strong> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">نتایج </span></span><span dir="LTR">FAHP</span><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> نشان می­دهد بعد</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">کیفیت دانش و مهارت پزشکی بیشترین</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">ضریب</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">اهمیت</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">را دارد. همچنین</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">با</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">تحلیل</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">داده­ها</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">با</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">استفاده</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">از </span></span><span dir="LTR">GRA-TOPSIS</span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">بیمارستان سوم،</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">رتبه</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">چهارم</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">را</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">در</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">ارائه</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">خدمات</span></span> <span style="font-family:B Roya;"><span style="font-size:11.5pt;">بدست آورد</span></span><span dir="LTR">.</span><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> همچنین نتایج نشان می­دهد که در بیمارستان سوم کیفیت دسترسی نیازمند بیشترین بهبود است.</span></span><br>
<strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;">نتیجه­گیری:</span></span></strong><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> روش </span></span><span dir="LTR">GRA-TOPSIS</span><span style="font-family:B Roya;"><span style="font-size:11.5pt;"> علاوه بر رتبه­بندی بیمارستان­ها بر اساس معیارهای کیفیت خدمات قادر است نقاط ضعف هر بیمارستان در هر یک از معیارها مشخص نماید. در نتیجه اولویت­های بهبود کیفیت خدمات در هر بیمارستان مشخص شد و بر اساس آن مدیر بیمارستان می تواند برای بهبود عملکرد در معیارهای که عملکرد پایینی نسبت به سایر بیمارستان­ها کسب کرده است، تلاش نماید. </span></span>
<strong>Background:</strong> Assessing and improving the quality of services in hospitals because deal with the health of humans is very important. The purpose of this study is to identify and weigh quality criteria and ranking of four hospitals in Mashhad.<br>
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<strong>Materials & Methods:</strong> The present study is of type Applied Studies that is a cross-sectional study conducted in the winter of 1396. In this study, by literature review, dimensions of service quality in the hospital was identified. Then, a paired comparison questionnaire (including 8 people) was used to conduct the survey. Then coefficients of importance of each dimension were calculated through the process of hierarchical analysis in a fuzzy environment. Decision-making matrix questionnaire was completed by a 400-person sample of patient companions in four hospitals.Then, hospitals were ranked using GRA-TOPSIS method. The validity of questionnaires were confirmed by the expert group.<br>
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<strong>Results:</strong>Using FAHP, knowledge and skills of medicine obtained the most important coefficient. Also, using GRA-TOPSIS, third hospital received the fourth place in the provision of services. Also in the third hospital the quality of access requires the greatest improvement.<br>
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<strong>Conclusion</strong>: In addition to ranking hospitals based on quality of service criteria, the GRA-TOPSIS method is able to identify each hospital's weaknesses in each criterion. As a result, the priorities for improving the quality of service in each hospital were identified, and the hospital manager could work to improve performance on the criteria that he or she achieved with lower performance than other hospitals.
بیمارستانها, کیفیت خدمات, تحلیل رابطه ایخاکستری- تاپسیس, تحلیل سلسله مراتبی فازی.
Hospitals, Service Quality, Analytic hierarchy process, Gray relational analysis -Topsis.
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http://jhosp.tums.ac.ir/browse.php?a_code=A-10-1419-1&slc_lang=fa&sid=1
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