Quality Evaluation of Health Services Using the Kano Model in Two Hospitals in Peru

Int J Environ Res Public Health. 2021 Jun 7;18(11):6159. doi: 10.3390/ijerph18116159.


Public-private partnerships (PPP) represent an alternative model of health management focused on improving the quality of health services, particularly in emerging countries. To date, a systematic method to improve the perceived quality of health services by healthcare users in Peru has not been established. The purpose of this study was to evaluate the quality of health services in two PPP hospitals in Peru using the Kano model. A prospective cross-sectional descriptive observational study was carried out through a health service satisfaction survey using the Kano model methodology, measuring six categories of attributes. A total of 250 users of the health services were surveyed in the two PPP hospitals, located in Lima and Callao, using non-probability convenience sampling. Of the 31 attributes evaluated by the patients, 27 (81%) were classified as having a one-dimensional-type attribute, 3 (10%) were reported as mandatory, and 1 (3%) was considered as inverse. These results suggest that the presence of most of the attributes evaluated was relevant to maintaining the level of user satisfaction and that the absence of these attributes generated dissatisfaction in the users. The results showed that the users' evaluation of health services was multidimensional-namely, their evaluation was focused not only on the interaction space between the patient and medical personnel but also addressed other interaction services.

Keywords: Kano model; Peru; health services; healthcare quality assessment; patient satisfaction; public–private sector partnerships.

Publication types

  • Observational Study

MeSH terms

  • Cross-Sectional Studies
  • Health Services*
  • Humans
  • Nigeria
  • Patient Satisfaction*
  • Peru
  • Prospective Studies
  • Quality of Health Care