Measuring and benchmarking the quality of two different organizational ways in delivering infant vaccination


Introduction: The aim of this study was the quality of service evaluation of two different organizational ways in delivering infant vaccination according to a Regional Vaccination Plan. Materials and Methods: Eleven vaccination centres were selected in two Local Health Units (ASLs) belonging to the Regional Health Service of the Lazio Region, Italy. The services offering paediatric vaccinations for children under three years of age, delivered with the need for an appointment (VACL) or else without an appointment (VACP), were investigated. The quality aspects under evaluation were communicational efficiency, organisational efficiency and comfort. Three steps are necessary to quantify the overall quality of service. Step 1 involves different stakeholders and the elicitation of best and worst feasible performance conditions for the ASLs when delivering VACP/VACL services (i.e., subjective data collection). Step 2 consists in the observation of current performances of the selected vaccination centres (i.e., objective data collection). Step 3 involves the combination of all data. Benchmarking between VACP and VACL, i.e., two different organisational ways in delivering infant vaccination, can be performed as a result of the probabilistic meaning of the evaluated scores. Results: An expert of vaccination services, i.e., a virtual combination of patients, doctors and nurses, claims the quality of service delivery of the ASLs under investigation with probability 78.03% and 69.67% for VACL and VACP, respectively. In other words, for short, the quality scores of the ASLs were 78.03% for VACP and 69.67% for VACL. Furthermore our results show how to practically improve the current service delivery.


Parasuraman A, Zeithaml VA, Berry LL. SERVQUAL: A multiple-Item Scale for measuring consumer perceptions of Service Quality. Journal of Rating 1988;1:12-40.

Ravichandran K, Tamil Mani B, Arun Kuma S, Prabhakara S. Influence of Service Quality on Customer Satisfaction: Application of Servqual Model. International Journal of Business and Management 2010;4:117-124.

Lin DJ, Sheu IC, Pai JY, Bair A, Hung CY, Yeh YH, Chou MJ. Measuring patient's expectation and the perception of quality in LASIK services. Health Qual Life Outcomes 2009;7:63.

Ryan M. Discrete choice experiments in healthcare. BMJ 2004;328:360-1.

Ryan M, Skåtun D. Modelling non-demanders in choice experiments. Health Econ 2004;13:397-402.

Donabedian, A. Evaluating the Quality of Medical Care. Milbank Memorial Fund Quarterly. 1966;.44 (1): 166-203.

Declaration of Alma-Ata International Conference on Primary Health Care, Alma-Ata, USSR, 6-12 September 1978

Coletti G, Paulon L, Scozzafava R and Vantaggi B. Measuring the Quality of Health-Care Services: A Likelihood-Based Fuzzy Modeling Approach Symbolic and Quantitative Approaches to Reasoning with Uncertainty Lecture Notes in Computer Science 2007; 4724: 853-864.


Maurici M, Meleleo C, Campolongo A, D'Anna C, Mangia ML, Sgricia S et al. Application of the QuavaTAR model to vaccination services in Latium, Italy. Ig Sanita Pubbl. 2010;66:793-801.

Maurici M, Paulon L, Campolongo A, Meleleo C, Carlino C, Giordani A, Perrelli F, Sgricia S, Ferrante M , Franco E; QuaVaTAR Group. Quality measurement and benchmarking of HPV vaccination services: a new approach. Hum Vaccin Immunother. 2014 Jan;10(1):208-15.

Regione Lazio. Decreti del Commissario ad Acta . Decreto del Commissario ad Acta 5 novembre 2012, n. U00192. Presa d'atto dell'Intesa ai sensi dell'art. 8 comma 6 della Legge 5 giugno 2003 n. 131 tra il Governo, le Regioni. e le Province autonome di Trento e Bolzano sul documento recante "Piano Nazionale Prevenzione Vaccinale 2012 - 2014". Piano Regionale Prevenzione Vaccinale 2012 - 2014.