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研究生:郭泰偉
研究生(外文):Tay-Woei Guo
論文名稱:民眾對抗老化醫學之服務缺口分析
論文名稱(外文):Service Quality Gap among People Receiving Anti-Aging Medicine
指導教授:鍾國彪鍾國彪引用關係
指導教授(外文):Kuo-Piao Chung
口試委員:黃松共蘇喜林承箕
口試日期:2015-07-24
學位類別:碩士
校院名稱:國立臺灣大學
系所名稱:公共衛生碩士學位學程
學門:醫藥衛生學門
學類:公共衛生學類
論文種類:學術論文
論文出版年:2015
畢業學年度:103
語文別:中文
論文頁數:103
中文關鍵詞:抗老化醫學服務品質服務缺口PZB服務品質衡量模式SERVQUAL量表
外文關鍵詞:Anti-Aging MedicineService QualityService Quality GapPZB Service Quality ModelSERVQUAL Model
相關次數:
  • 被引用被引用:3
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※背景與目的:
隨著全民健康保險制度的開辦導致醫療環境的變遷,以及高齡社會的來臨、我國人口結構與疾病型態的改變,加上抗老化醫學的興起,越來越多的民眾在疾病發生之前已經開始尋求預防醫學健康管理與抗老化醫學的協助。然而,在目前的全民健康保險制度之下,抗老化醫學多不屬於健保給付範圍,民眾若有自身健康需求必須自費,其單次花費往往達到新台幣數千到數萬元不等,在高消費的同時,抗老化醫學機構所提供之服務與民眾理想接受到的服務品質間,當中滿意度存在多少服務缺口,是此產業必須關注且正視的重要議題。
※研究方法:
本研究為橫斷性研究,經挑選於抗老化醫學產業中具有口碑之機構進行收案,收案對象分為二類,一為接受抗老化醫學服務之民眾,另一則是抗老化醫學機構醫療團隊成員。問卷以PZB服務品質模式理論為基礎,參照SERVQUAL量表以建立適用於抗老化醫學產業的服務品質評估指標,在評估服務品質認知與達成程度採用李克特七點量表(Likert scale)的方式作為調查工具。本研究將收集到的資訊以描述性統計、兩獨立樣本 t 檢定、相依樣本 t 檢定、單因子變異數分析(ANOVA)、因素分析方法做資料分析。收案期間為2015年5月6日至2015年6月15日,期間內共計發出民眾版問卷78份,回收60份(回收率76.92%);醫療團隊版問卷45份,回收39份(86.67%);合計共發出123份問卷,回收99份(回收率80.49%),有效問卷為99份。
※研究結果:
服務缺口分析之前,量表在信度檢驗上Cronbach''s Alpha 達到0.9以上,在適用性檢定KMO 值達0.8 以上。主成分分析與最大變異轉軸法所得的分析結果之因素負荷量除了兩題項未達0.5外其餘皆高,因本研究使用發展成熟之PZB服務品質模式與SERVQUAL量表故題項皆予以保留。在服務品質缺口一:抗老化醫療團隊對於民眾心目中理想期待服務品質認知差距部分,結果顯示在五大構面皆有進步的空間,其中以反應性表現(平均值為 0.552)和關懷性表現(平均值為0.505)差距最大。在服務品質缺口五:民眾實際感受服務品質達成程度部分,缺口差距較大的為可靠性表現(平均值為 1.867)、關懷性表現(平均值為1.657)。在缺口五與抗老化民眾人口學特性分析部分,51~65 歲年齡區間族群,其在反應性、關懷性構面的服務品質表現滿意程度高於41~50 歲、31~40 歲年齡區間;經濟狀況富裕的民眾在反應性構面的服務品質滿意程度高於經濟狀況為小康、足夠的族群。在缺口一與抗老化醫療團隊人口學特性分析部分,問卷填寫者身份為醫師的受訪者,其在可靠性、反應性、關懷性構面方面對於預估抗老化醫學民眾之服務品質期待認知較為保守。
※結論:
本研究認為抗老化醫學機構與醫療團隊應優先加強可靠性、反應性、關懷性三大服務品質構面產生之缺口,逐步縮小各品質構面缺口之落差,甚至高於民眾期待。此外,在有形性表現部分雖然缺口差距較小,但加強該缺口表現可使抗老化醫學民眾對服務品質改善有立即感知。在進一步分析人口學特性後,醫療機構與照護團隊對年齡層低於51~65 歲的年齡區間、經濟狀況非富裕程度的族群,應投入更多關注以全面提照護升服務品質;抗老化醫療團隊應與民眾進行更多互動與溝通,讓民眾充分了解其接受療程內涵,使其對治療結果有合理的期許而非抱持過高的醫療期待,避免療程結果不如預期時造成更大的服務缺口。

※Background and Objective:
Since the initiating of National Health Insurance (NHI), it led to a dramatic change in healthcare environment. Followed by a transition to an aging society and the transformation of population structure and diseases patterns in Taiwan, more and more people have taken notice of the emerging health technology of anti-aging medicine and preventive medicine. However, under the reimbursement policy of NHI, most of the anti-aging medicines are not covered while patients in need should fully pay their regimens by themselves, which cost approximately thousands to tens of thousands. As a result, how well delivered anti-aging medicines and health management services conform to the patients’ expectations will be an important issue in the anti-aging and preventive medicines industries.
※Methods:
This cross-sectional study was performed in a few selected anti-aging medicine agencies that were highly praised in the industries. A self-developed questionnaire based on the characteristics of PZB Service Quality Model and SERVQUAL Model were delivered and recovered from 6th May to 15th June 2015. A Likert Scale was used as a survey tool to examine the difference between expected and perceived service quality. “Provider” is the medical team of the anti-aging medicine agencies, and “Client” is the patient who receives the anti-aging medicine services. In terms of Client, 78 questionnaires were sent out whilst 60 subjects responded (response rate: 76.92%). On the part of Provider, 45 questionnaires were sent out while 39 subjects responded (response rate: 86.67%). Overall, 99 effective samples were obtained (response rate: 80.49%). The collected samples were analyzed through some statistical tests, including independent-samples t test, paired-samples t test, one-way ANOVA, and factor analysis.
※Results:
The self-developed questionnaire was validated by reliability test with a Cronbach’s alpha over 0.9 and with a Kaiser-Meyer-Olkin value over 0.8 in factor analysis. The factor loadings derived from Principal Component Analysis and Varimax Rotation showed that all the items exceeded 0.5 except 2 items among them. Nevertheless, the 2 items were retained in the consideration of the well-developed PZB Service Quality Model and SERVQUAL Model. The results showed that all 5 dimensions in the difference between client’s expectation and provider’s perception (Gap 1) still had much room for improvement, with the largest gaps observed in “responsiveness”(mean: 0.552) and “empathy”(mean:0.505). Furthermore, the gap between the clients'' expectations and their perceptions of the quality of provided services (Gap 5) is much higher in the dimensions of "reliability" with a mean of 1.867, and “empathy” with a mean of 1.657. Among the Gap 5 and the studied clients'' demographic characteristics, “age group 51-65 y/o” had higher service quality satisfaction than “age group 41-50 y/o” and “31-40 y/o” in dimensions of “responsiveness” and “empathy”; on the other hand, clients with higher income level had higher service quality satisfaction in “responsiveness”. In addition, among the Gap 1 and the studied providers'' demographic characteristics, subjects whose occupation is “physician” had more conservative attitude in anticipating clients’ expectation in the dimensions of “reliability”, “responsiveness” and “empathy”.
※Conclusion:
Overall, the results of the present study suggested providers should prioritise the clients'' views in the service quality dimensions of “reliability”, “responsiveness” and “empathy”, in order to abate the gaps or even surpass clients’ expectation. Although the gap in the dimension of tangibles was smaller, enhancing the performance in this gap could strengthen clients’ perception to the improvement of service quality. According to the result of further analysis of demographic characteristics, providers should devote more attention to clients younger than 51-65 y/o or with lower income level (unwealthy). The medical teams of anti-aging medicine agencies should interact and communicate with clients more frequently in order to well inform them of the detail in the course of treatment and avert unappropriate expectation to the treatment outcome. Therefore, it might avoid further deteriorating clients’ satisfaction to the service quality.

第一章 導論 - 2 -
第一節 實習單位特色與簡介 - 2 -
第二節 研究背景和動機 - 5 -
第三節 研究目的 - 6 -
第二章 文獻探討 - 7 -
第一節 抗老化醫學 - 7 -
第二節 醫療照護服務特性 - 9 -
第三節 醫療照護服務品質衡量 - 12 -
第四節 PZB 服務品質的衡量方式 -18 -
第五節 PZB 服務品質模式與 SERVQUAL 量表於醫療上之應用 -21 -
第六節 綜合討論 - 22 -
第三章 研究方法 - 23 -
第一節 研究設計與研究架構 - 23 -
第二節 研究對象與資料蒐集 - 24 -
第三節 研究假說 - 26 -
第四節 研究工具與變項定義 - 27 -
第五節 資料處理及分析方法 - 40 -
第四章 資料分析結果 - 42 -
第一節 問卷因素分析與信度檢定 - 42 -
第二節 研究對象描述性統計 - 43 -
第三節 PZB 服務品質模式缺口一之描述性與推論性分析 - 47 -
第四節 PZB 服務品質模式缺口五之描述性與推論性分析 - 56 -
第五節 服務品質缺口與人口學特性比較 - 63 -
第六節 抗老化民眾就醫選擇 - 73 -
第五章 討論 - 75 -
第一節 研究資料品質 - 75 -
第二節 討論 - 76 -
第三節 研究限制 - 78 -
第六章 結論與建議 - 80 -
第一節 結論 - 80 -
第二節 未來研究建議 - 81 -
參考文獻 - 83 -
附錄 - 86 -

※英文文獻
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※中文文獻
1.中華民國國家發展委員會. (2014). 中華民國人口推計(103至150年). from http://www.ndc.gov.tw/m1.aspx?sNo=0000455#.VLu4g0eUeL0
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5.盧瑞芬, & 謝啟瑞. (2003). 台灣醫院產業的市場結構與發展趨勢分析. [An Analysis of the Market Structure and Development of Taiwan''s Hospital Industry]. 經濟論文叢刊, 31(1), 107-153. doi: 10.6277/ter.2003.311.5
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