Development and Validation of a Service Quality Assessment System for Chronic Disease Management in Primary Healthcare: a Multi-Site Cross-Sectional Study

This study developed and validated a service quality assessment system for primary chronic disease management using Delphi-AHP methods. Psychometric evaluation, including exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), across five centers confirmed high reliability. A comparative analysis showed that the AHP-SERVQUAL framework has higher predictive power for patient adherence than the KANO or TOPSIS-RSR models.