The negative gap in quality of elderly healthcare in the West of Iran in 2020; an analytical cross-sectional study

Abstract

Introduction: Immune system dysfunction in old age leads to infectious diseases, autoimmunity and a high prevalence of various cancers in the elderly. Assessing the quality of services provided to the elderly and identifying its strengths and weaknesses can help improve elderly health and increase the quality of life-related to health. Objectives: We aimed to assess the quality gap in an integrated healthcare program for the Iranian elderly. Participants and Methods: This cross-sectional study was conducted on 701 elderly individuals aged over 60 years in Hamadan by stratified random sampling. Interviewers visited the selected centers on random days of the week and completed the SERVQUAL questionnaire. Data were analyzed by Stata 13, using ANOVA and a multiple linear regression model at a 95% confidence interval. Results: The mean age of the participants was 68.38±6.90 years and the majority of them were women (59.63%). The mean of expected quality was higher regarding all the dimensions compared to the mean of perceived quality (P<0.001). In addition, women had higher expectations of quality services than men (4.13 versus 4.12) (P=0.390). Compared to the urban elderly, the rural elderly had a higher mean of perceived service quality score (0.12), which was statistically significant (P=0.003). Conclusion: The results indicated a negative gap between the mean of expected quality and the mean of perceived quality. This gap was greater in terms of access to expected needs. Thus, paying attention to the unmet needs of the elderly should be a priority for health policymakers.