Designing a Qualitative Model of Citizen Participation to Improve the Quality of Healthcare Services (Case Study: Zabol Hospitals)
Keywords:
Participation, Citizens, Healthcare ServicesAbstract
Citizen participation in the healthcare sector, particularly in improving the quality of medical services, plays a highly significant role. This participation not only contributes to enhancing service quality but also leads to increased patient satisfaction, transparency within the healthcare system, and greater accountability among officials. The purpose of this research was to design a qualitative model of citizen participation aimed at improving the quality of services delivered in the healthcare domain. This study is applied in terms of purpose and descriptive–survey in terms of data collection, conducted in the field. The statistical population included hospital managers, healthcare and treatment specialists, physicians, paramedics, and faculty members of Zabol University of Medical Sciences. In total, 56 individuals were selected for the qualitative sample. The required information was obtained through interviews in order to identify the effective criteria for citizen participation in healthcare services, and then extracted for analysis. The results indicated six main criteria: altruistic participation; investment-based participation; organizational and institutional participation; participation through feedback and hospital service performance; participation through hospital suggestion systems; and participation through legal supervision of citizen involvement in healthcare. Altogether, these dimensions reveal that citizen participation can only lead to improved quality of healthcare services if it is simultaneously strengthened at the individual and altruistic level, supported through investment and organizational mechanisms, integrated into decision-making via authentic feedback and suggestions, and institutionalized through legal and supervisory frameworks. In other words, each of these criteria together construct a comprehensive model of citizen participation that can pave the way for a sustainable and effective enhancement of the healthcare system.
Downloads
References
[1] J. W. Higgins, "Citizenship and empowerment: a remedy for citizen participation in health reform," Community Development Journal, vol. 34, no. 4, pp. 287-307, 1999, doi: 10.1093/cdj/34.4.287.
[2] L. Williamson, "Patient and citizen participation in health: the need for improved ethical support," The American journal of bioethics, vol. 14, no. 6, pp. 4-16, 2014, doi: 10.1080/15265161.2014.900139.
[3] M. Serapioni and N. Duxbury, "Citizens' participation in the Italian health-care system: the experience of the Mixed Advisory Committees," Health Expectations, vol. 17, no. 4, pp. 488-99, 2014, doi: 10.1111/j.1369-7625.2012.00775.x.
[4] T. Mannarini and A. Fedi, "The quality of participation in the perception of citizens: Findings from a qualitative study," Community psychology: New developments, pp. 177-92, 2010.
[5] D. R. Luisi and K. Hämel, "Understandings of community participation and empowerment in primary health care in Emilia-Romagna, Italy: A qualitative interview study with practitioners and stakeholders," Plos one, vol. 19, no. 9, p. e0310137, 2024, doi: 10.1371/journal.pone.0310137.
[6] C. J. Frankish, B. Kwan, P. A. Ratner, J. W. Higgins, and C. Larsen, "Challenges of citizen participation in regional health authorities," Social Science & Medicine, vol. 54, no. 10, pp. 1471-80, 2002, doi: 10.1016/S0277-9536(01)00135-6.
[7] E. Richardson et al., "User involvement in regulation: A qualitative study of service user involvement in Care Quality Commission inspections of health and social care providers in England," Health Expectations, vol. 22, no. 2, pp. 245-53, 2019, doi: 10.1111/hex.12849.
[8] H. Waddington, A. Sonnenfeld, J. Finetti, M. Gaarder, D. John, and J. Stevenson, "Citizen engagement in public services in low- and middle-income countries: A mixed-methods systematic review of participation, inclusion, transparency and accountability (PITA) initiatives," Campbell Systematic Reviews, vol. 15, no. 1-2, p. e1025, 2019, doi: 10.1002/cl2.1025.
[9] H. Alami, M. P. Gagnon, and J. P. Fortin, "Involving citizen-patients in the development of telehealth services: qualitative study of experts' and citizen-patients' perspectives," Journal of Participatory Medicine, vol. 10, no. 4, p. e10665, 2018, doi: 10.2196/10665.
[10] H. Jennings, M. Slade, P. Bates, E. Munday, and R. Toney, "Best practice framework for Patient and Public Involvement (PPI) in collaborative data analysis of qualitative mental health research: methodology development and refinement," BMC psychiatry, vol. 18, no. 1, p. 213, 2018, doi: 10.1186/s12888-018-1794-8.
[11] M. Areia et al., "Public involvement in chronic respiratory diseases research: A qualitative study of patients', carers' and citizens' perspectives," Health Expectations, vol. 27, no. 1, p. e13917, 2024, doi: 10.1111/hex.13917.
[12] P. Saini et al., "The value of involving patients and public in health services research and evaluation: a qualitative study," Research involvement and engagement, vol. 7, no. 1, p. 49, 2021, doi: 10.1186/s40900-021-00289-8.
[13] A. Renedo and C. Marston, "Spaces for citizen involvement in healthcare: an ethnographic study," Sociology, vol. 49, no. 3, pp. 488-504, 2015, doi: 10.1177/0038038514544208.
[14] Z. Gao, S. Wang, and J. Gu, "Public participation in smart-city governance: A qualitative content analysis of public comments in urban China," Sustainability, vol. 12, no. 20, p. 8605, 2020, doi: 10.3390/su12208605.
[15] Z. Zhen, "The Impact of Digital Technology on Health Inequality: Evidence From China," BMC Health Services Research, vol. 24, no. 1, 2024, doi: 10.1186/s12913-024-12022-8.
[16] I. Steenkamp, "Digital Health Readiness – Insights From Healthcare Leaders in Operational Management: A Cross-Sectional Survey," BMC Health Services Research, vol. 25, no. 1, 2025, doi: 10.1186/s12913-024-12129-y.
[17] H. Golabchi, M. Kiaee, and M. J. Kameli, "Designing a Superior Service Delivery Model in Education to Enhance Public Satisfaction," (in eng), Iranian Journal of Educational Sociology, Research Article vol. 7, no. 1, pp. 189-197, 2024, doi: 10.61838/kman.ijes.7.1.18.
[18] S. Rawal, "Mental Health Awareness and Access to Services in Postpartum Women," Journal of Pharmacy and Bioallied Sciences, vol. 17, no. Suppl 1, pp. S417-S419, 2025, doi: 10.4103/jpbs.jpbs_1593_24.
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
Copyright (c) 2025 Mohammad Ali Mir , Kamaleddin Rahmani Youshanloui, Mojtaba Ramazani , Davood Paydarfard (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
