Multilevel Factors Shaping the Patient Experience with Health Services in Torbat Heydarieh, Iran

Fatemeh Pourhaji, Public Health Department, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran, Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran; AND Social Determinants of Health Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Follow
Mohammad Hossein Delshad, Public Health Department, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran, Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran; AND Social Determinants of Health Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran Follow

ORCID

Mohammad Hossein Delshad: https://orcid.org/0000-0002-3512-9010

Abstract

Background: One of the main aims of public health is to ensure that health services are used and available. However, access alone does not guarantee a positive patient experience, which is critical to achieving optimal health outcomes and ensuring health equity. Aims: The objective of this study is to analyse in a comprehensive way the multiple factors influencing the patient experience and subsequent use of healthcare services by households in Torbat Heydarieh, Iran, by examining the independent and interactive contributions of individual, household and environmental (community) determinants using THUMS data. Methods: This analytical study, which covered a 1-year period, looked at data from December 2022 to December 2023 for all sites in the area of university services. Researchers used a stratified sampling methodology of multiple stratification of clusters for the selection of 580 affected households. 580 households were interviewed in person and through structured questionnaires. The data were analysed by the researchers using the statistical software STATA 16. Results: The average lifespan of the household heads was 48.5 years (± 12.3). A multilevel regression analysis showed that individual variables such as education (OR = 3.10) and health literacy (OR = 2.43) strongly predicted the use of services. Crucially, environmental factors that directly influence patients' experiences, such as greater distance to healthcare services (Far vs. Near; OR = 0.75, 95% CI: 0.45–0.94), the presence of a reliable means of transportation (Yes vs. No; 95 % CI: 1.25–2.85; OR = 1.89), were significantly associated with uptake (High vs. Low; 95 % CI: 0.68–0.95, OR = 0.80), were substantially linked to utilization. Individuals visited a doctor on average 2.5 times a year (95 % confidence interval: 2.1–2.9). Thirty-two percent of respondents reported having been hospitalized at least once in the last year (95% CI: 29–36). Patient satisfaction data showed high satisfaction with staff courtesy (87.1%), but significant dissatisfaction with affordability (42.6%) and accessibility (44.8%) of services, indicating critical issues in patient care. According to 43% of survey participants, healthcare is reasonably priced. The university's service system's predetermined health care facilities were the ones taken into account when calculating utilization. Conclusion: The study shows that in addition to individual factors, key patient experience factors such as geographical distance, transportation and deprivation play a significant and independent role in shaping healthcare engagement in Torbat Heydarieh. These findings highlight that improving the patient experience requires comprehensive interventions that address not only individual capabilities, but also underlying community-level barriers to access and affordability.

Recommended Citation

Pourhaji F, Delshad M. Multilevel Factors Shaping the Patient Experience with Health Services in Torbat Heydarieh, Iran. Patient Experience Journal. 2026; 13(1):360-369. doi: 10.35680/2372-0247.2110.