A Study on Improving the Quality of Adult Day Care Services Using Kano–QFD Integrated Analysis

Purpose: The purpose of this study is to identify priorities for service quality improvement in adult day care services based on users’ perceptions and to translate these priorities into actionable quality management strategies.Methods: Through FGI conducted with adult day care center users and staff, service quality attributes were derived. To analyze the asymmetric structure of satisfaction and dissatisfaction responses, Kano and Teamco's CSC framework was applied. The PCSI Index, reflecting current satisfaction levels, was combined with importance ratings to create a Revised Importance metric, which was used as the customer requirement weighting in QFD analysis. Finally, the HOQ was employed to measure correlations between customer requirements and service characteristic.Results: Items related to mobility support, prompt staff response, emotional interaction, and basic health support showed high importance and high PCSI values. QFD analysis using the Revised Importance as weights identified safety management, health management, emotional support, and mobility management as the top priority technical characteristics for improving day care service quality. And analysis among service characteristics confirmed that physical activity and information management functions are linked to multiple domains such as health, safety, meals, and mobility.Conclusion: This study presented an analytical framework integrating Kano–CSC–PCSI–QFD to connect user needs to actionable quality improvement strategies. Specifically, the modified importance score, reflecting both importance and room for improvement, refined the prioritization of technical characteristics, providing an empirical basis for resource allocation, operational improvement, and quality management decision-making in day care centers.