臺灣博碩士論文加值系統

本研究旨在了解血液透析院所轉換者對轉換成本、轉換意圖與轉換院所服務滿意度之認知。研究對象為設置在台北市、新北市、桃園縣市與新竹市之九家血液透析院所病患，總計發出450份問卷，回收有效問卷408份，有效回收率為90.67%。
研究結果顯示：血液透析院所轉換者知覺到轉換成本之「設置成本」與「不確定成本」較高，而造成轉換意圖之前三個因素依序是醫師服務態度、醫師醫術、與更彈性的洗腎時段；團體娛樂活動、團體衛教服務、與營養餐點提供並非轉換意圖之成因。而對於轉換後院所之服務滿意度前三名則依序為轉診或轉介住院的服務、醫師服務態度、及護理人員服務態度；不滿意者為團體娛樂活動、團體衛教服務與營養餐點。
本研究針對結果與發現，建議血液透析院所應致力於醫護人員對病患在病情與血液透析習慣的深入瞭解，增加對下一家轉換院所之不確定性，並提高醫師服務知能及院所彈性週邊服務之精緻程度，使患者轉換成本增加，進而降低轉換意圖與行為。

This study aims to investigate hemodialysis patient’s switching inten-tion, switching cost and after-switch satisfaction. The research subjects are the patients at the nine Hemodialysis Centers in Taipei, NewTaipei, Taoyuan and HsinChu city. In total 450 copies of questionnaire are dis-tributed, in which 408 copies of is effective questionnaires are responded with effective response rate at 90.67%.
The results show, that hemodialysis patient’s perceived 'setup cost' and 'uncertainty uncertainty cost' are high, an outcome that causes the first three factors of switching intention in sequence are doctor's attitude, doctor's skill and more flexible dialysis sessions. Group entertainment activity and nutritious meals service are not among the factors of switching intention. With regard to after-switch satisfaction, what are listed in the first three items include hospitalization transfer service, attitude of attendant physician and attitude of nurses.
This study suggests that dialysis centers should endeavor to train medical care staff to have a deeper understanding of patient's condition, increasing the uncertainty of next switched center, improving doctors’ skills in services and exquisiteness of center's flexible service, hence in-creasing the patient's switching cost and decreasing switching intention and behavior.

目 次
長庚大學碩士學位論文指導教授推薦書 ii
長庚大學碩士學位論文口試委員會審定書 iii
國家圖書館博碩士論文電子檔案上網授權書 iv
長庚大學博碩士論文著作授權書 v
致 謝 vi
中文摘要 vii
ABSTRACT viii
目 次 ix
圖 次 xi
表 次 xii
第一章 緒論 1
第一節 研究背景與動機 5
第二節 研究目的與研究問題 7
第二章 文獻探討 8
第一節 轉換成本 8
第二節 轉換意圖 11
第三節 服務滿意度 13
第四節 血液透析院所病患之相關研究 15
第三章 研究方法 17
第一節 研究設計 17
第二節 統計方法 24
第四章 研究結果 25
第一節 樣本基本資料分析 25
第二節 敘述性統計 35
第三節 討論 41
第五章 結論與建議 45
第一節 結論 45
第二節 管理意涵 45
第三節 研究限制與未來研究建議 49
參考文獻 50
附錄一 63
附錄二 66
圖 次
圖1-1 1999年~2010年血液透析人數成長趨勢 1
圖1-2 門診透析支付標準 2
圖1-3 血液透析之院所數與治療床數 3
表 次
表3-1 受測院所規模與問卷回收份數表...................................... 17
表3-2 預試問卷之轉換成本構面內容...................................... 21
表3-3 正式調查問卷之轉換成本構面內容............................... 22
表3-4 預試問卷題項修訂比較表.............................. 23
表4-1 性別與年齡統計表............................... 26
表4-2 教育程度、就業與否與每月收入統計表............................... 27
表4-3 居住地與單程交通耗時統計表............................... 28
表4-4 搭乘交通工具統計表............................... 29
表4-5血液透析治療中是否須陪伴人與陪伴對象統計表.......................... 30
表4-6 接受血液透析治療年數、每次治療時間、有無慢性疾病與其佔率統計表............................... 32
表4-7 過去曾有其他院所透析經驗統計表............................... 33
表4-8 原血液透析院所有無提供非醫療額外服務與影響決定血液透析院所人選統計表............................... 34
表4-9 轉換成本同意程度排序............................... 36
表4-10轉換意圖同意程度排序............................... 38
表4-11服務滿意度排序............................... 40

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