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研究生:劉復興
研究生(外文):FU-SHING LIU
論文名稱:醫療院所層級與病患個人特質對就醫行為之影響–以中部都會區30-40歲婦產科病患為例
論文名稱(外文):The Influence of the Scales of Medical Institutes and Patients’ Characteristics on Medical Care Seeking Behaviors – Considering Obstetrics and Gynecology Patients Aged between 30 to 40 Years in the Urban Area of Mid-Taiwan
指導教授:蔡禎騰蔡禎騰引用關係
指導教授(外文):JEN-TENG TSAI
學位類別:碩士
校院名稱:東海大學
系所名稱:工業工程與經營資訊學系
學門:工程學門
學類:工業工程學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:72
中文關鍵詞:醫療院所病患特質就醫行為婦產科都會區
外文關鍵詞:Medical InstitutesPersonal CharacteristicsObstetrics and GynecologyMedical Seeking BehaviorUrban area
相關次數:
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醫療產業屬於服務業的一環,因此提供好的醫療服務品質對醫療服務者應是責無旁貸的工作。自從全民健保開辦以來,醫療產業間更是競爭激烈,如何提升服務品質以增加顧客滿意度已是醫療經營者念茲在茲的重要課題。
而探討分析民眾的就醫行為,了解消費者的需求,可為提升服務品質的重要參考。環顧國內外,此一方面的研究報告亦所在多有。在婦產科醫療方面,由於其醫療性質的特殊性,婦產科病患在就醫時的考量因素和就醫行為值得特別研究。近年來國外學者對於婦產科病患就醫行為之研究報告已是屢見不鮮,然在國內,此一方面的研究仍是極為闕如。
本研究之目的旨在探討都會區婦女在就診婦產科時,其個人背景之差異是否會影響其對婦產科醫師,和醫療院所之考量因素與就醫行為。藉由此研究結果我們希望能夠得知國內婦女目前就醫婦產科之現況,並對婦產科醫療院所及婦產科醫師在營運決策上提供一些有用的資訊,以謀求提供婦女最佳的就醫品質。增進醫病關係,並提升病患就醫之滿意度。
經由對台中都會區的醫學中心、中型醫院、和婦產科診所病患所作之結構性訪談分析結果,我們得到以下之結論:1.單身女性於就診婦產科時對於醫師和院所的選擇較已婚女性採取更為審慎的態度。2. 教育程度較低之女性比教育程度較高之女性更重視婦產科醫師的醫術,對於就醫場所也有較多的考量。3. 婦女的職業大致上並不影響其對婦產科醫師、醫療院所的考量以及就醫行為。4. 家庭經濟收入並不影響婦女對婦產科醫師和醫療院所的考量因素。但在就醫行為方面,家庭經濟收入較低之婦女較無固定之婦產科就醫場所。5. 都會區婦女在就診婦產科時明顯地有醫院取向和診所取向兩個族群。6. 都會區婦女就診婦產科時雖然會選擇不同的就醫場所,但是其對醫師和院所的考量因素並無顯著差異。醫師方面,婦女們最重視的是醫術、看診態度、和專業程度。院所方面,最重視的是環境整潔、醫療設備是否新穎完善,以及員工的服務態度。7. 婦產科醫師的性別、年齡、和宗教信仰是都會區婦女就診婦產科時最不重視的考量因素。
  從以上之研究結果我們除建議婦產科醫療之提供者應特別著重婦女對醫師和院所的考量因素外,婦產科醫療之提供者並可經常性地對他們的病患進行滿意度調查,如此可適時地知道不同背景的病人在就診時比較重視的是什麼樣的考量,而在上述基本之服務項目外更推展服務個人化和精緻化以滿足病患之需求。
It is the responsibility of medical care providers to provide good quality of medical care. Since the implementation of national health insurance scheme in Taiwan, promoting service quality and increasing consumers satisfaction have become more important topics for the medical care managers because of the keen competition in medical business.
Via researching and analyzing people’s medical care seeking behavior to understand what consumers need is an indispensable method to promote service quality. Such studies have been widely reported in literature. However, obstetrics and gynecology patients may differ from general patients in terms of the unique nature of this discipline. It is therefore necessary to investigate this specific topic.
The aim of the study is to find out whether different scale of medical institutes and personal characteristics will influence women’s concern on selecting obstetrical and gynecological service. We hope this study can provide some helpful information to the obstetrical and gynecological care providers.
Through a structural interview to the patients of obstetrical and gynecological clinics at three scales of medical institutes in Taichung city (medical centers, regional hospitals, and private clinics) we have the following findings: 1. Single women and women with lower education level are more deliberate in selecting obstetrical and gynecological doctors and medical institutes than married women and women with higher education level, respectively. 2. Generally, occupation and family income do not affect women’s choice for obstetrical and gynecological doctors and medical institutes. 3. Women in urban region have a bi-polar tendency in selecting medical institutes for their obstetrical and gynecological care, i.e., either hospital or private clinic, few mixture of the two. 4. In spite of the difference in selecting medical institutes, urban women have similar concerns on the factors that they think important in obstetrical and gynecological care. For selecting physicians, their experience, attitude, and professional expertise are the prioritized concerned factors. For selecting medical institutes, their environment, facility, and service quality are most important. 5. Physician’s gender, age, and religion background are the factors that are thought least important to concern.
We therefore suggest that the physicians and medical institutes offering obstetrical and gynecological service should strengthen the items that women are most concerned. In addition, interval interview to the consumers may gain more information about what they really need and so that better medical care can be provided.
目 錄
頁次
中文摘要 ………………………………………………………………I
英文摘要 ……………………………………………………………III
誌 謝 ………………………………………………………………...V
目 錄 ………………………………………………………………. VI
圖 目 錄 ………………………………………………………….… IX
表 目 錄 ………………………………………………………………X
第一章 緒論 …………………………………………………………1
1.1 研究背景與動機 …………….……………………………… 1
1.1 研究目的 …………………………………………………… 3
1.2 研究對象與範圍 …………………………………………… 3
1.3 研究流程 …………………………………………………… 4
第二章 文獻探討 …………………………………………………… 6
2.1 民眾對醫療服務的評估與選擇模式 ………………….…… 6
2.2 就醫行為之影響因素 ………………………………………. 8
2.3 婦產科病患就醫行為之研究 ………………………………10
第三章 研究方 ………………………………………………..……. 14
3.1 研究架構 …………………………………………………….14
3.2 研究假設 ……………………..…………………………… 16
3.3 研究變項與操作型定義 …………………..……………… 16
3.4 研究設計 …………………………………..……………… 23
3.5 資料收集與分析 ………………………..………………… 24
第四章 研究結果 ………………………………….……………… 26
4.1 受訪者個人特質與就醫行為的分析結果 ……..………… 26
4.2 受訪者個人特質在就醫行為和對婦產科醫師、醫療院所考量因素之相關性分析 ………………..……………………… 27
4.3 受訪者個人特質與選擇就醫場所之相關性分析 …..…… 46
4.4 受訪者就醫行為與選擇就醫場所之相關性分析 …..…… 47
4.5 選擇不同層級婦產科醫療院所之病患對婦產科醫師和院所的考量因素分析 ……………………………..…………… 49
4.6 受訪者就醫行為對婦產科醫師和院所的考量因素分析…..53
第五章 研究結論與建議 ……………………………..…………… 58
5.1 討論與結論 ……………………………..…………………. 58
5.2 研究限制 ………………………………..…………………. 63
5.3 研究建議 ……………………………..……………………. 65
參考文獻 …………………………………………..………………… 67
附 錄 …………………………………………………………..…… 71
一、中文文獻
王乃弘、黃松共。民眾對選擇醫院因素及態度之研究 - 以中部數家醫院為例。醫院 1996;30(2):1-15。
周逸衡、黃毓瑩、陳華寧。消費者對醫療服務的評估與選擇模式。醫院 2005;38(2):36-51。
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陳筱華,祝道松,徐永新。病患選擇醫院之關鍵因素及決策行為- 以產科病人為例.醫務管理期刊. 2001;2:77-92.
曾倫崇。顧客選擇醫院就診因素之研究 - 以行銷觀點。醫院 1997;30(6):28-37。
蔡文正、龔佩珍。民眾對基層診所評價與就醫選擇影響因素。台灣衛誌 2003;22(3):181-93。
葉季森、林平衡、尹磊君。孕婦選擇生產場所相關因素研究-以台中地區數家醫療機構為例。醫護科技學刊 2006;8(2):144-56。
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