Improving Quality in Public Health Service: An Integrated Approach to the Kano Model and the Balanced Scorecard

ABSTRACT There is growing interest in evaluating the quality of services provided. This has allowed government program and policy makers to identify bottlenecks and highlight requirements that lead to the optimization of public resources. Furthermore, the supply of public health services tends to be precarious in developing countries due to increased demand and diminished resources. Thus, this paper proposes an integrated approach to the Kano Model and the Balanced Scorecard perspectives for improving public hospital services. The investigation was carried out in a Brazilian public hospital. The hospital is known as a regional reference center in several medical specialties and one of the pioneers in total quality programs in public hospitals in the country. This study is original because it developed a new approach that integrates the BSC and the Kano Model for the context of health services. The association between these methodologies is useful for strategic planning and a better understanding by managers of the aspects that most impact patient satisfaction in the public hospital. This approach allows hospital public managers to assess the program’s internal efforts to combat neglected diseases and improve patient adherence indicators for treatment. The assessments can also be used as monitoring tools and parameters so that decision makers can make improvements in public health actions.