臺灣博碩士論文加值系統

全民健保自民國八十四年三月一日起開辦至今已逾十一年，由於全民健保是一項社會福利，攸關到全國百姓的健康醫療照護的保障，再加上健保局自從成立之後，財務連年歸損問題受到立法諸公及全國百姓的關注；各醫院之間相互競爭日趨激烈，就醫民眾在選擇醫療院所的範圍因而更廣泛。由於消費者擁有自由就醫的選擇權益，而醫療服務品質與地點的方便性逐漸成為選擇醫院的主要考量因素。因此，為了吸引就診之顧客及獲取其對醫院的信賴，醫院開始著重於醫療服務品質上的改善。在顧客為導向的時代裡，我們都有一致的認同：「開發新顧客所花的成本是維繫舊顧客的五倍，因為要使顧客轉換品牌或廠商是件高成本、高代價的事。」基於上述理由，醫療院所為了維持舊有的顧客，使顧客滿足，就必須先了解民眾在就醫時所重視的因素為何，才能擬訂合適的改善策略，提升整體的服務品質。
本研究探討「醫療品質」、「知覺價格」、「顧客關係」、「就醫者滿意度」「服務價值」等五項因素，影響就醫者進行醫療美容的「行為意圖」；研究分析方法分為「假設檢定」及「路徑分析」二種方式，結果發現：
(1).「顧客關係」、「就醫者滿意度」、「服務價值」等三項因素，均對「行為意圖」有正向效果的影響。「醫療品質」必須透過「就醫者滿意度」及「服務價值」的提昇，才能對「行為意圖」產生影響。
(2). 整體而言，間接效果以「顧客關係」與「服務價值」對「行為意圖」為最佳路徑。
(3). 整體而言，直接效果以「顧客關係」為最重要。
(4). 整體而言，總效果以「顧客關係」為優先考量。
(5). 「顧客關係」、「服務價值」、「就醫者滿意度」對「推薦行為」產生顯著影響。
(6). 「顧客關係」、「服務價值」、「就醫者滿意度」對「再診行為」產生顯著影響。
(7). 「醫療品質」、「知覺價格」、「就醫者滿意度」對「抱怨行為」產生顯著影響。
(8). 「知覺價格」、「顧客關係」對「轉換行為」產生顯著影響。
藉由顧客關係的改善，進一步影響就醫者滿意程度的提升，就能夠提升消費者再度回診的意願及願意推薦親朋好友前來就診，且可以有效規避現有的消費者的抱怨行為及轉換至其他醫療院所的行為。當就醫者對醫療品質認知程度越高時，越會將在醫療過程中所遇到的難題，向其他人抱怨或是向有關單位及醫護人員反應，同時，若是消費者認知價格與獲得的相對品質成反比、顧客關係不如預期的良好、整體的滿意度下降，其轉換行為就會增加。因此，消弭抱怨行為的發生，提升推薦行為及再診行為的意願，就能有效規避患者轉換行為的發生。

As of March 1, 1995, Taiwan’s National Health Insurance has been established for more than 11 years. Since then, the financial loss of the Bureau has been concerned by the public in the past consecutive years. Competition among hospitals is getting more intense day by day, which provide the public a wider range of choices of medical centers. In this customer-oriented age the capital for developing new customers is five times more than the capital for keeping existing ones; it takes a lot of capital and a high cost job to change the habits of customers to use other unfamiliar brands or suppliers. In order to keep the existing customers and satisfy them, medical centers need to know what the important factors are for the public upon their admissions to hospitals, so that appropriate improvement strategies can be made and the quality of the service can be improved.
This study discusses five factors, “health care quality”, “perceived price”, “customer relationship”, “patient satisfaction”, and “service value”, which affect the “behavioral intentions” of patients on medical cosmetology processes. The results indicated that:
1. All three predicators, “customer relationship”, “patient satisfaction”, and “service value”, affect “behavioral intention” positively. “Health care quality” would affect “behavioral intention” only when “patient satisfaction” and “service value” have been improved.
2. Overall, the best indirect effect on “behavioral intention” must come from the “customer relationship” and “service value”.
3. Overall, the most important factor for direct effect is “customer relationship”.
4. “Customer relationship” will be firstly considered for the overall effect.
5. “Customer relationship”, “service value” and “patient satisfaction” would affect “recommendation behavior” significantly.
6. “Customer relationship”, “service value” and “patient satisfaction” would affect “readmission behavior” significantly.
7. “Health care quality”, “perceived price” and “patient satisfaction” would affect “complaint behavior” significantly.
8. “Perceived price” and “customer relationship” would affect “switching behavior” significantly.
Through the improvement of customer relationship, the patient satisfaction will be affected and increased, which would then increase the intentions of consumers to return and recommend friends or relatives to go to the same medical center. Consequently, it may effectively avoid complaint behavior from the existing customers and prevent them from switching to other medical centers. When patients know more about health care quality, they will express more things, problems and difficulties, about their medical care experiences to other people or related working unit and medical staff. Meanwhile, if the quality customers receive is opposite to their perceived values, the customer relationship would be worse than the expected and the overall satisfaction would decrease, which would lead to increased switching behavior. Therefore, eliminating the complaint behavior, increasing the recommendation behavior and increasing the readmission behavior would effectively avoid the switching behavior of the patients.

第一章 緒論 1
1.1研究背景 1
1.2研究動機 1
1.3研究目的 3
1.4研究流程 4
第二章 文獻探討 5
2.1醫療品質 5
2.2知覺價格 13
2.3顧客關係 18
2.4就醫者滿意度 22
2.5服務價值 25
2.6行為意圖 31
第三章 研究方法 37
3.1研究架構 37
3.2研究假設 38
3.3變數的操作性定義 41
3.4研究對象 44
3.5抽樣方法 44
3.6問卷設計 45
3.7分析方法 50
第四章 資料分析與探討 52
4.1樣本描述 52
4.2效度與信度之檢定 54
4.3假設檢定 62
4.4路徑分析 77
4.5行為意圖之子構面分析82
第五章 結論與建議 85
5.1研究結論 85
5.2研究建議 87
5.3研究限制與未來研究方向92
參考文獻 94

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