SciELO - Scientific Electronic Library Online

vol.44 issue2Evaluation of the effectiveness of a training program for knowledge in hypertensive patientsSocioeconomic and sociocultural dynamics in the prevalence of respiratory symptoms in Peruvian women from the rural areas author indexsubject indexarticles search
Home Pagealphabetic serial listing  

Services on Demand




  • Have no cited articlesCited by SciELO

Related links

  • Have no similar articlesSimilars in SciELO


Revista Cubana de Salud Pública

Print version ISSN 0864-3466On-line version ISSN 1561-3127


PEREZ PULIDO, Miguel Oswaldo; ORLANDONI MERLI, Giampaolo; RAMONI PERAZZI, Josefa  and  VALBUENA VENCE, Miguel. Perceptive analysis of the quality in health services´ delivery with a Six-Sigma approach. Rev Cubana Salud Pública [online]. 2018, vol.44, n.2, pp.325-343. ISSN 0864-3466.


Ensuring access to quality health services is one of the necessary conditions for reducing poverty and inequality in a country.


To analyze the perception of quality in the provision of health services in a public care hospital.


A cross-sectional study of patients treated from March to April 2016 in the emergency and outpatients clinics of Lázaro Alfonso Hernández Lara Hospital, in Colombia. The sample included 220 patients that were randomly selected. Six sigma methodology which is useful for organizing the continuous improvement of health services was applied. Data from the target population were obtained through the SERVQUAL survey, which measures the perception of quality.


Regarding the perceived quality of care, the security dimension appeared confused with empathy, and as a differentiating factor, the comfort dimension emerged, separated from tangible elements. The overall rating of perception confirmed that about 50% of patients had low perceptions on the quality’s dimensions assessed.


Patients show low quality’s perception regarding the health services they receive. This makes possible to recommend hospital directives to review the processes related to the quality of the services provided, and to propose improvement policies in the emergency and outpatient areas, according to the needs and conditions of the users.

Keywords : Total quality’s management; quality of health care; factorial analysis.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )