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Review
. 2025 Jan 22;8(1):e70362.
doi: 10.1002/hsr2.70362. eCollection 2025 Jan.

Service Quality in Iranian Hospitals From Patients' Perspectives Based on the SERVQUAL Model: A Systematic Review and Meta-Analysis

Tara Alizadeh  1 , Marzieh Jahani Sayad Noveiry  1 , Samad Karkhah  1 , Ehsan Kazemnezhad Leyli  2 , Kobra Salami Kohan  3   4 , Pooyan Ghorbani Vajargah  1
Affiliations
Review

Service Quality in Iranian Hospitals From Patients' Perspectives Based on the SERVQUAL Model: A Systematic Review and Meta-Analysis

Tara Alizadeh et al. Health Sci Rep. .

Abstract

Background: This study aimed to evaluate the service quality in Iranian hospitals from patients' perspectives based on the SERVQUAL model.

Materials and methods: A thorough exploration of online electronic databases, including Scopus, PubMed, Web of Science, IranMedex, and the Scientific Information Database (SID), was undertaken using keywords extracted from Medical Subject Headings such as "Quality of Health Care," "Hospital," and "Patients" spanning from the earliest available records up to August 11, 2023.

Results: In the context of 25 cross-sectional studies encompassing a collective participant pool of 8021 hospitalized patients in Iranian medical facilities, an assessment of patients' perspectives on the quality of hospital services revealed a mean perception score of 3.54 (SE = 0.08). Concurrently, the mean expectation score for the quality of services was determined to be 4.43 (SE = 0.06). Using the SERVQUAL model, the overall disparity between patients' perceptions and expectations was calculated as -0.89. Subsequent examination of specific dimensions within the SERVQUAL framework revealed gaps between patients' perceptions and expectations in the tangibility dimension (-0.84), reliability dimension (-0.94), responsiveness dimension (-0.91), assurance dimension (-0.89), and empathy dimension (-0.82).

Conclusion: Therefore, healthcare administrators consider the study's findings as a motivating force to initiate measures aimed at improving service quality in Iranian hospitals. Tackling the recognized shortcomings and areas requiring enhancement holds the promise of raising patient satisfaction levels and, consequently, improving overall healthcare outcomes.

Keywords: hospital; meta‐analysis; patients; quality of healthcare; systematic review.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Flow diagram of the study selection process.
Figure 2
Figure 2
Assessment of the quality of the included articles.
Figure 3
Figure 3
Forest plot of patients' perceptions based on the SERVQUAL model.
Figure 4
Figure 4
Forest plot of patients' expectations based on the SERVQUAL model.
Figure 5
Figure 5
Meta‐regression based on the relationship between the patients' perceptions based on the SERVQUAL and years of publications.
Figure 6
Figure 6
Meta‐regression based on the relationship between the patients' expectations based on the SERVQUAL and years of publications.
Figure 7
Figure 7
The mean patient perception based on the SERVQUAL model in the subgroup of location.
Figure 8
Figure 8
The mean patient expectation based on the SERVQUAL model in the subgroup of location.
Figure 9
Figure 9
Sensitivity analysis of patients' perceptions based on the SERVQUAL model.
Figure 10
Figure 10
Sensitivity analysis of patients' expectations based on the SERVQUAL model.
Figure 11
Figure 11
Funnel plot of patients' perceptions based on the SERVQUAL model.
Figure 12
Figure 12
Funnel plot of patients' expectations based on the SERVQUAL model.
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