Evaluation of the quality of public health services: A study in the Brazilian context

Renata Pase Ravanello; Kelmara Mendes Vieira; Breno Augusto Diniz Pereira; Renata Pase Ravanello; Kelmara Mendes Vieira; Breno Augusto Diniz Pereira

doi:10.3934/publichealth.2026003

AIMS Public Health

2026, Volume 13, Issue 1: 32-49. doi: 10.3934/publichealth.2026003

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Research article

Evaluation of the quality of public health services: A study in the Brazilian context

Graduate Program in Public Organizations Management, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

Received: 21 October 2025 Revised: 07 December 2025 Accepted: 13 December 2025 Published: 06 January 2026

This study investigated Brazilians' perceptions of public health service quality using a multidimensional approach with a national sample. A survey involving 1229 respondents from all regions of Brazil was analyzed through descriptive statistics and confirmatory factor analysis to validate the measurement model. Service quality was assessed using the PUBLICSERV scale, comprising seven dimensions: tangible aspects, reliability, relationship, public value, transparency, equality and legality, and satisfaction. The model showed good fit and validity. Findings revealed that most Brazilians perceive service quality as average across the dimensions. Public value received the highest ratings, highlighting recognition of the services' social importance. Tangible aspects and reliability were lowest, pointing to shortcomings in infrastructure and consistency of care. Transparency was evaluated as moderate, while equality and legality reflected perceived fairness. The relationship dimension was rated positively, suggesting empathy and commitment from health professionals. Overall, satisfaction was reported, though tempered by structural and consistency issues. The results emphasize the value of multidimensional assessments in understanding user experiences, suggesting that improvements in infrastructure and consistency are important to strengthen public health delivery, while maintaining the positive aspects recognized by users, such as social relevance, fairness, and professional commitment.
- health quality management,
- public health services,
- health service evaluation,
- health evaluation,
- PUBLICSERV
Citation: Renata Pase Ravanello, Kelmara Mendes Vieira, Breno Augusto Diniz Pereira. Evaluation of the quality of public health services: A study in the Brazilian context[J]. AIMS Public Health, 2026, 13(1): 32-49. doi: 10.3934/publichealth.2026003

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Abstract

This study investigated Brazilians' perceptions of public health service quality using a multidimensional approach with a national sample. A survey involving 1229 respondents from all regions of Brazil was analyzed through descriptive statistics and confirmatory factor analysis to validate the measurement model. Service quality was assessed using the PUBLICSERV scale, comprising seven dimensions: tangible aspects, reliability, relationship, public value, transparency, equality and legality, and satisfaction. The model showed good fit and validity. Findings revealed that most Brazilians perceive service quality as average across the dimensions. Public value received the highest ratings, highlighting recognition of the services' social importance. Tangible aspects and reliability were lowest, pointing to shortcomings in infrastructure and consistency of care. Transparency was evaluated as moderate, while equality and legality reflected perceived fairness. The relationship dimension was rated positively, suggesting empathy and commitment from health professionals. Overall, satisfaction was reported, though tempered by structural and consistency issues. The results emphasize the value of multidimensional assessments in understanding user experiences, suggesting that improvements in infrastructure and consistency are important to strengthen public health delivery, while maintaining the positive aspects recognized by users, such as social relevance, fairness, and professional commitment.

Acknowledgments

The authors did not receive funding for this research.

Authors' contributions

Conceptualization, R.P.R., K.M.V. and B.A.D.P.; methodology, R.P.R., K.M.V. and B.A.D.P.; software, R.P.R. and K.M.V.; formal analysis, R.P.R, K.M.V. and B.A.D.P.; investigation, R.P.R, K.M.V. and B.A.D.P.; data curation, R.P.R. and K.M.V.; writing—original draft preparation, R.P.R., K.M.V. and B.A.D.P.; writing—review and editing, R.P.R., K.M.V. and B.A.D.P.; project administration, K.M.V.; funding acquisition, R.P.R., K.M.V. and B.A.D.P.. All authors have read and agreed to the published version of the manuscript.

Conflict of interest

The authors declare no conflicts of interest.

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