本研究欲探討影響花蓮地區病患或家屬選擇就醫途徑的因素。藉以了解花蓮慈濟醫院如何透過頻脊的環境下決定正確的經營策略？病患或家屬在就醫前主要是透過哪些機制了解醫院，願意放心托付此醫院的醫療服務？病患需要醫療服務時，如果平時沒有對所在地區的醫院與醫師有所了解，會不會有病急亂投醫的情況發生？並參考國內外相關文獻，選定知覺品質、市場行家、顧客承諾、口碑、行為意圖與經驗品質作為本研究之變數。以花蓮慈濟醫院之醫療病患為研究對象，採問卷調查方式針對醫療病患對於個案醫院關係行銷與信任、忠誠度之關係進行調查。經資料分析結果有以下幾點重要發現：1.知覺品質在病患的心目中是最重要的，其它依序為市場行家、顧客承諾、口碑、行為意圖與經驗品質。2.行為意圖對於口碑的傳播有相關正向影響。3.經驗品質越高，就醫選擇將對有行為意圖正向影響。4.就醫者有較高的經驗品質，將會超越知覺品質。5.顧客承諾越高對口碑溝通有相關正向影響。6.知覺品質與顧客承諾二者間對口碑溝通有顯著交互影響關係。7.市場行家的形成，將影響知覺品質與顧客承諾。
並根據以上研究結果提出下列幾點建議：
1.應加深社區醫療衛教互動：透過醫護人員進入社區進行衛教，拉近彼此的關係，也能提升市場的口碑，讓一般民眾的知覺品質趨於正向。
2.應加強在地化公開活動營造：應與政府機構合作，在公開場合舉辦各類活動，改善本地人對醫院的口碑，藉以培養出願意與他人分享口碑的市場行家。
3.重視不同的市場區隔，擬定客製化的行銷策略：不管是哪種人口區隔特性的顧客，都要針對醫療院所可能忽視的地方予以加強，擬定客製化的行銷策略並實行之。

This research is to discuss the impact factors for patients and their family members selecting hospital in Hualien. To know how the Buddhist TZU CHI General Hospital makes the correct business strategy decisions in the barren environment. To know what mechanisms the patients and their family members are through and willing to entrust the hospital medical services. To know if the patients will go to the hospitals even they do not know the hospitals and doctors well. This research refers to the relevant literature to select perceived quality, market maven, customer commitment, word-of-mouth, behavioral intentions, and quality of experience as the research variables. The patients in Buddhist TZU CHI General Hospital are the research samples, and the questionnaire survey is used in this research to investigate the relationship between the relationship marketing and trust and loyalty. The data analysis results are as following: 1. Perceived quality is important for patients and follows by market maven, customer commitment, word-of-mouth, behavioral intentions, and quality of experience. 2. Behavioral intentions will positive affect word-of-mouth. 3. With higher quality of experience, medical treatment options will have positive affect on behavioral intentions. 4. Patients with higher quality of experience will be beyond the perceived quality. 5. Higher customer commitments will positive affect word-of-mouth. 6. Perceived quality and customer commitment will positive interaction word-of-mouth. 7. The formation of market maven will affect the perceived quality and customer commitment.

Based on the findings to provide some suggestions:

1.To enhance the health education and interactive in the communities: the health care workers go into the communities through the patient instructions to make the relationship between the public and the hospital get closer to improve the reputation in the market that makes the public has positive perceive quality.
2.To strengthen and create the public activities: to corporate with government agencies to hold various activities to improve the hospital reputation and word-of-mouth and to foster market experts who are willing to share reputation with others.
3.To respect different market segments and develop the customized marketing strategy: no matter the population with different characteristics, the hospital should strengthen and improve the customized marketing strategies.

誌謝 ii
摘要 iii
Abstract iv
目錄 v
表目錄 viii
圖目錄 ix
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 2
第三節　研究流程與研究步驟 3
第二章 文獻探討 7
第一節 花蓮慈濟醫院的緣起 7
第二節 行為意圖（Behavioral intentions） 8
一、行為意圖的定義與意義 8
二、行為意圖的分類 9
第三節 口碑（word-of-mouth） 16
一、口碑的定義 16
二、其他與口碑有關之文獻 17
第四節 經驗品質（Quality of experience, QoE） 21
一、經驗品質的定義 21
二、其他與經驗品質有關之文獻 22
第五節 顧客承諾（customer commitment） 25
一、顧客承諾之意義 25
二、其他與顧客承諾有關之文獻 26
第六節 知覺品質（Perceived Quality） 28
一、知覺品質之定義 28
二、知覺品質的構面 29
三、其他與知覺品質有關之研究 30
四、知覺品質與口碑溝通之關係 31
第七節 市場行家（market maven） 33
一、市場行家之起源與定義 33
二、市場行家之動機 34
三、市場行家之重要性 34
四、其他與市場行家有關之文獻 35
第三章 研究方法與假設 37
第一節 研究架構 37
第二節 抽樣設計 37
第三節 問卷設計 38
第四章 研究結果分析 41
第一節 敘述性統計分析 41
第二節 效度與信度 41
第三節 變異數分析 41
第四節 迴歸分析 41
第五節 次數分配與描述性統計 42
一、個人基本背景之描述 42
二、題項平均數與標準差之描述 44
第五節 問卷效度與信度分析（CFA） 47
一、信度分析 47
二、效度分析 48
第六節 整體結構方程模式分析 50
一、整體模式說明 51
二、分析結果 51
三、假說關係驗證 54
第五章 研究結論、建議與限制 55
第一節 研究結論 55
第二節 研究建議 57
第三節 未來研究建議 58
第四節 本研究限制 60
參考文獻 61
英文參考文獻 61
中文參考文獻 72

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