臺灣博碩士論文加值系統

本研究目的即在探討醫療服務品質對病患滿意度之影響，進而研究病患滿意度與行為意向之間的關係。醫療院所之間競爭激烈，病患服務滿意度是評估醫療品質的指標之一，故必須重視病患滿意度來提升醫療品質，藉由滿意程度的分析，了解病患之不滿意之處，故探討病患在服務品質及滿意度對病患推薦行為意向之影響。
本研究以中部某區域教學醫院的住院病患為研究對象，採結構性問卷調查法，以隨機抽樣方式調查，共發出750份問卷，回收720份，有效問卷630份，問卷回收率為96.0%，問卷有效回收率為84.0%。研究主要採用SPSS 14.0統計套裝軟體來分析資料，使用的分析方法有描述性統計分析、驗證性因素分析、線性迴歸分析、羅吉斯迴歸分析、變異數分析與獨立樣本t檢定、卡方獨立性檢定，探討醫療服務品質、滿意度和行為意圖間之關係。
結果顯示，醫療服務品質對滿意度有顯著正向影響，當住院病患知覺醫療服務品質越高其醫療滿意度會有顯著提昇；滿意度對行為意向有顯著正向影響，即當顯示滿意度是正向影響住院病患的推薦意願，亦即住院病患對病房環境設施、工作人員的服務態度、醫療過程方面、醫院的行政效率方面、抱怨的立即獲得處理以及出院前病症的改善等方面的綜合滿意愈高，則向親友推薦的意向程度就愈高；醫療服務品質的結構面與結果面對行為意向具有顯著正向影響，然而過程面卻不具有顯著性。
本研究之結論在管理上的意涵有：
1.強化專業醫療多功能性服務。醫療院所不僅是治病的場所，需要整合資源多角化經營，滿足不同層次顧客之需求。
2.重視醫療過程面，因是一種人際面的互動過程，藉以將技術面之照護成功的執行，而住院病患的推薦意向最終還是要看醫療技術面的成功或不成功而定。掌握病患行為意向即掌握未來。故教育訓練，宜加入『人際互動課程』，以達專業與親切的標準化服務。
3.提升主管管理格局，運用對組織的向心力，發揮團隊綜效。舉辦行政管理課程，透過教育訓練來強化其對醫院文化的認知與全方位經營管理能力。
4.市場區隔之檢視。以提升醫療市場佔有率，邁向永續經營之契機。

This research goal namely in discussion medical service quality to the influence of the satisfaction degree of patient, then further advance to research the relationship between the satisfaction degree of patient and behavior intention. Between the medical institutes intensive competition, the satisfaction degree of patient’s service appraises one of the medical quality targets, must therefore take the satisfaction degree of patient to promote the medical quality, according to the satisfaction analysis, understanding the patient’s unsatisfaction, therefore discuss the service quality of the patient and degree of satisfaction to the patient recommendation behavior intention influence.
This research take some of the central region teaching hospital''s inpatients as the object of study, picks the constitutive questionnaire survey procedure, by the random sampling way investigation, altogether sent out 750 questionnaire, recycled 720, effective questionnaire 630, the questionnaire returns-rate was 96.0%, the questionnaire effective returns-rate was 84.0%. The research mainly used the SPSS 14.0 statistics coverall software analyze data, the using analysis method had the descriptive statistical analysis, the confirmatory factor analysis, the linear regression analysis, the Rogis regression analysis, the variance analysis and the independent sample “t “examination, the card side independence examination, the discussion of the relationship between the medical service quality, the satisfaction degree of patient and the behavioral intention.
The result showed that the medical service quality had the remarkable forward influence to the degree of satisfaction, when the inpatient’s awaring medical service quality was higher, its degree of medical satisfaction will have the remarkable promotion; The degree of satisfaction to behavioral intention had the remarkable forward influence , namely worked as the demonstration degree of satisfaction is to have the forward influence in inpatient’s recommended intention, that is the inpatients facing the hospital ward environment facility, staff''s service attitude, the medical procedure aspect, the hospital administrative efficiency aspect, the complaint obtaining and processing as well as the improving of illness before discharging from the hospital and so on the satisfaction of improvements was higher, then the intention of the recommendation to the relatives and friends will be higher; The medical service quality''s structural side and result had the remarkable forward influence in front of the behavioral intention , however the process side actually was not remarkable .
Conclusion of this research included in the management meaning:
1. Strengthens the specialized medical multi-purpose services. The medical institute, is not only the place treating illness, it needs conformity of resources for multi-angles management, to satisfy the need of the different levels of customers.
2. Valuing the medical process side, because it is one kind of interpersonal interactive process, so as to illumination of the technical protection was successfully hold, but it was the inpatient’s recommendation intention to look at the medical technology side finally decides success or not , and to win the loyalty and the positive reputation with every effort. Handling the patient’s behavior intention namely therefore handling the future. Thus the training education, it is suitable to add ''the interpersonal interactive curriculum'', to reach affective and professional standardized service.
3. Promotes the manager’s managing style, operates the organization''s centripetal force, and displays the synthetic effect of the team. Conducting the administration curriculum, strengthens the hospital culture cognition and omni-directional management and administration ability by the education training
4. The inspection of the separation of the market. To promotes the medical market occupying rate, and advances to the eternal management
Key word: Medical Service Quality,
Satisfaction, Behavioral Intention

目 錄
第一章 緒論…………………………………………………… 01
第一節 研究背景與動機……………………………………… 01
第二節 研究目的……………………………………………… 03
第三節 研究對象與範圍……………………………………… 04
第四節 研究流程……………………………………………… 05
第二章 文獻探討……………………………………………… 06
第一節 服務品質……………………………………………… 06
第二節 滿意度………………………………………………… 19
第三節 行為意向……………………………………………… 24
第三章 研究設計……………………………………………… 27
第一節 研究架構………………………………………………… 27
第二節 研究假設…………………………………………… 28
第三節 操作性定義………………………………………… 30
第四節 資料收集與分析…………………………………… 35
第四章 資料分析結果………………………………………… 38
第一節 樣本結構……………………………………………… 38
第二節 驗證性因素分析與信效度考驗…………………… 41
第三節 醫療服務品質、滿意度、行為意向之關係……… 48
第四節 人口統計變項對醫療服務品質與滿意度之差異… 55
第五節 人口統計變項對行為意向之關係………………… 62
第五章 結論與建議…………………………………………… 68
第一節 研究結論……………………………………………… 68
第二節 研究建議…………………………………………… 75
第三節 研究限制…………………………………………… 76
第四節 後續研究方向……………………………………… 77
參考文獻………………………………………………………… 78
中文文獻………………………………………………………… 78
英文文獻………………………………………………………… 81
附錄 問卷……………………………………………………… 91

圖目錄
圖1-1 研究流程圖……………………………………………05
圖2-1 服務品質模式…………………………………………10
圖2-2 行為意向圖……………………………………………24
圖3-1 研究架構圖……………………………………………27

表目錄

表2-1 服務品質之衡量構面與變項意義………………………10
表2-2 服務品質之定義…………………………………………11
表2-3 國外、國內學者提出醫療服務品質構面………………16
表2-4 病患滿意度之衡量構面…………………………………22
表2-5 行為意向量表……………………………………………25
表3-1 醫療服務品質衡量問卷…………………………………31
表3-2 滿意度衡量問卷…………………………………………33
表3-3 人口統計變項問項………………………………………34
表4-1 就醫背景次數分配………………………………………40
表4-2 服務品質結構面之驗證性因素分析……………………42
表4-3 服務品質過程面之驗證性因素分析……………………44
表4-4 服務品質結果面之驗證性因素分析……………………45
表4-5 住院病患滿意度之驗證性因素分析……………………46
表4-6 醫療服務品質對住院病患滿意度之迴歸分析…………50
表4-7 醫療服務品質過程面對住院病患滿意度之迴歸分析…51
表4-8 住院病患滿意度與推薦意願之羅吉斯迴歸係數………52
表4-9住院病患滿意度對推薦意願之正確預測與錯誤預測次數分配 表…………………………………………………………………52
表4-10 醫療服務品質與推薦意願之羅吉斯迴歸係數……… 54
表4-11 醫療服務品質對推薦意願之正確預測與錯誤預測次數分配表…………………………………………………………………54
表4-12 初次住院對醫療服務品質與滿意度之差異分析…… 56
表4-13 就診科別對醫療服務品質與滿意度之差異分析…… 57
表4-14 性別對醫療服務品質與滿意度之差異分析………… 58
表4-15 年齡層對醫療服務品質與滿意度之差異分析……… 59
表4-16 教育程度對醫療服務品質與滿意度之差異分析…… 60
表4-17 居住地對醫療服務品質與滿意度之差異分析……… 61
表4-18 初次就診住院與行為意向之交叉分析……………… 62
表4-19 就診科別與行為意向之交叉分析…………………… 63
表4-20 性別與行為意向之交叉分析………………………… 64
表4-21 年齡與行為意向之交叉分析………………………… 65
表4-22 教育程度與行為意向之交叉分析…………………… 66
表4-23 居住地與行為意向之交叉分析……………………… 67
表4-24 研究假設結果………………………………………… 67

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