臺灣博碩士論文加值系統

醫療服務品質報告（卡），在先進國家已行多年，但是對臺灣的民眾卻是嶄新的一頁，多數民眾仍然對其十分陌生。健保局高屏分局從2002年開始提供醫療服務品質報告，供民眾上網查詢高屏澎地區各級醫療院所之醫療服務品質，藉以提供民眾就醫之選擇，並提升院所之醫療服務品質。
本研究採問卷方式去探討高屏地區門診病人對健保局高屏分局「醫院醫療服務品質報告」的認知、態度、期望以及就醫前之資訊選擇，希望對醫療服務品質報告（卡）的推行盡一份心力。
本研究結果顯示，多數病人（78.6%）不知道有此報告，表示有關單位應加強宣導，但是在了解醫療服務品質報告後，多數人認為有助於選擇醫院（77.4%），83.2%的病人認為有助於提升醫療服務品質。當常去看診之醫院其醫療服務品質報告評比不佳時，62.3%的病人會考慮更換醫院；如果常去看診之醫院未參與醫療服務品質報告評比時，46.1%的病人會考慮更換醫院。
研究結果同時指出，70%的病人希望增加醫療服務品質報告的品項，其中以藥物錯誤率項目（62.7%）最高，其次是醫院評鑑結果（57.2%）、病患意外醫療糾紛紀錄（45.1%）、手術後感染率（44.9%）、事件發生率（44.1%）。71.9%門診病人希望醫院醫療服務品質報告改為強制醫院參與，顯著差異的變項：年齡、教育程度、職業類別、平均月收入、慢性病、區域醫院與醫學中心的病人等項。74.7%門診病人希望醫院醫療服務品質報告擴大到全國，顯著差異的變項：年齡、教育程度、職業類別、平均月收入、慢性病、居住地、區域醫院與醫學中心的病人等項。78.4%門診病人希望醫院醫療服務品質報告的政策繼續實施下去，顯著差異的變項：年齡、教育程度、職業類別、平均月收入、慢性病、居住地、區域醫院與醫學中心的病人等項。

Public report cards on health care were performed in many countries for decades. But it is a new policy to Taiwanese. The Kao-Ping Branch of Bureau of National Health Insurance has providing a website of“Hospital Medical Care Quality Reports”since 2002 that will be good for patient to select hospital and to stimulate quality improvement of hospital.
The result of this study showed 78.6% persons of interview have never heard this website, 83.2% persons thought “Hospital Medical Care Quality Reports”would be helpful to improve medical care quality of hospital, and 77.4% persons thought “Hospital Medical Care Quality Reports”would provide them some useful information to select hospital. There were 62.3% patients would shift to better hospital whenever he found the hospital was not good enough in the evaluation of report card.
According to this study 70% patients wanted to increase items of report card especially in drugs errors. In the other questionnaire item 71.9% of patients hoped to impose all of hospitals to attend the evaluation of medical care quality reports.

誌謝 I
中文摘要 II
英文摘要 IV
目錄 VI
表目次 IX
圖目次 XII
附錄目錄 XIII
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第三節 研究重要性 4
第二章 文獻探討 5
第一節 醫療服務品質的定義與指標 5
第二節 何謂品質報告卡 7
第三節 醫院品質報告卡之發展 8
第四節 消費者對使用品質報告卡的態度及使用情形 9
第五節 醫院品質報告卡的指標項目 10
第六節 臺灣之醫院品質報告卡情形 11
第三章 研究方法 17
第一節 研究架構 17
第二節 研究變項及其操作型定義 19
第三節 研究假設 23
第四節 研究對象及流程 24
第五節 研究工具 26
第六節 資料處理與分析方法 27
第四章 研究結果 28
第一節 問卷回收情形與特性 28
第二節 描述性統計 29
第三節 推論性統計 41
第五章 結果與討論 85
第一節 門診病人就醫前資訊選擇 85
第二節 門診病人對醫療服務品質報告的態度 87
第三節 門診病人對醫療服務品質報告的期望 89
第六章 結論與建議 90
第一節 結論 90
第二節 建議 92
第三節 研究限制 94
參考文獻 95
中文部分 95
英文部分 97
表目次
頁數
表2-1、醫院品質報告之國外文獻..........................................................13
表2-2、醫院品質報告之國內文獻........................................................15
表3-1、研究變項之操作型定義及選項..................................................19
表3-2、研究變項之操作型定義及選項..................................................21
表4-1、受訪民眾基本特質......................................................................30
表4-2、門診病人就醫前資訊選擇..........................................................32
表4-3、門診病人對「醫院服務品質報告卡」的態度..............................35
表4-4、門診病人對「醫院服務品質報告」的期望..................................39
表4-5、門診病人特質與「是否知道醫療服務品質報告」之相關性42
表4-6、影響門診病人就醫前資訊選擇之因素
－是否知道醫療服務品質報告................................................43
表4-7、門診病人特質與「下次就醫是否會查詢醫療服務品質報告」之相關性....................................................................................46
表4-8、影響門診病人就醫前資訊選擇之因素
－下次就醫是否會查詢醫療服務品質報告..............................47
表4-9、門診病人特質與「就醫參考重要性」之相關性.....................50


頁數
表4-10、影響門診病人對醫院醫療服務品質報告的態度之因素－就醫參考重要性............................................................................51
表4-11、門診病人特質與「能否提升醫療品質」之相關性............54
表4-12、影響門診病人對醫院醫療服務品質報告的態度之因素－能否提升醫療品質........................................................................55
表4-13、門診病人特質與「能否幫助選擇醫院」之相關性............58
表4-14、影響門診病人對醫院醫療服務品質報告的態度之因素－能否幫助選擇醫院........................................................................59
表4-15、門診病人特質與常就診之醫院評比不佳是否考慮更換醫院」之相關性................................................................................62
表4-16、影響門診病人對醫院醫療服務品質報告的態度之因素－常就診之醫院評比不佳是否考慮更換醫院................................63
表4-17、門診病人特質與「常就診之醫院未參加評比是否考慮更換醫院」之相關性........................................................................66
表4-18、影響門診病人對醫院醫療服務品質報告的期望之因素－常就診之醫院未參加評比是否考慮更換醫院............................67
表4-19、門診病人特質與「是否該增加醫院醫療服務品質報告項目」之相關性表............................................................................70
頁數
表4-20、影響門診病人對醫院醫療服務品質報告的期望之因素－是否該增加醫院醫療服務品質報告項目.....................................71
表4-21、門診病人特質與「是否該強制醫院參與」之相關性.........74
表4-22、影響門診病人對醫院醫療服務品質報告的期望之因素－是否該強制醫院參與.....................................................................75
表4-23、門診病人特質與「是否該實施到全國」之相關性.............78
表4-24、影響門診病人對醫院醫療服務品質報告的期望之因素－是否該實施到全國.........................................................................79
表4-25、門診病人特質與「政策是否該繼續實施」之相關性.........82
表4-26、影響門診病人對醫院醫療服務品質報告的期望之因素－政策是否該繼續實施.....................................................................83

圖目次
頁數
圖3-1、研究架構圖..............................................................................18
圖3-2、研究流程..................................................................................25


附錄目錄
頁數
附錄一 原始問卷..................................................................................107
附錄二 專家內容效度審查者名單......................................................112
附錄三 問卷專家效度評鑑表..............................................................113
附錄四 正式使用的研究問卷..............................................................118

中文部分
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