臺灣博碩士論文加值系統

肝臟是人類的一個重要器官，肝臟移植手術的捐贈者、受贈者及家屬在接受移植手術前後，常有憂鬱、沮喪、生氣及害怕的情緒反應，移植手術帶給病患及家屬的恐懼是涉及身體及心理層面。根據健保局的分析，我國肝臟移植人數呈現上升趨勢，2001～2004年有418例、2005～2008年有978例、2009～2011年有1227例，在此趨勢下病患及家屬對於醫療服務品質之期望更為殷切。相較於過去多由醫生主導醫病過程，醫療機構面臨競爭激烈的經營環境，病患有更多選擇權的情勢下，醫院生存競爭必須思考如何轉向提高醫療服務品質，取得病患再次就醫的意願，才能達成醫院永續經營的目標。
SERVQUAL將服務質量分為五個層面：有形性(Tangibles)、可靠性(Reliability)、反應性 (Responsiveness)、保證性(Assurance)、關懷性(Empathy)，每一層面又被細分為若干個問題，透過問卷調查的方式，讓用戶對每個問題的期望值、實際感受值及最低可接受值進行評分。並由其確立相關的22個具體因素來說明它。然後透過問卷調查、顧客打分和綜合計算得出服務質量的分數。近十年來，該模型已被管理者和學者廣泛接受和採用。模型以差別理論為基礎，即顧客對服務質量的期望，與顧客從服務組織實際得到的服務之差別。模型分別用五個尺度評價顧客所接受的不同服務之服務質量。研究表明，SERVQUAL適合於測量訊息系統服務質量，SERVQUAL也是一個評價服務質量和用來決定提高服務質量行動的有效工具。數十年來，通訊技術與資訊的發展有很大的進步。商業交易也從原先傳統的面對面互動模式轉變為透過網路進行資訊傳遞與流通，消費者也愈趨重視資訊品質。
本研究以Parasuraman,Zeithaml及Berry等三位學者定義之服務品質為研究主軸，探討透過網路服務平台是否能提升醫病雙方的關係品質。服務品質包含有形性、可靠性、反應性、保證性、關懷性。研究者首先進行質性訪談，接著以問卷調查方式測量樣本之醫療服務體驗，研究樣本為台中某大醫院之肝臟移植病患，總計有效樣本為117份，有效問卷回收率為75%，以一般迴歸進行假設驗證。研究結果顯示，架設資訊平台之後在病患照護資訊品質感受是大幅提升的，病患忠誠度也有顯著提升，然而病患對於有形性及反應性的感受是下降的。

The liver is an important organ of human beings. Donors, recipients and family members of liver transplant surgery often have depression, depression, anger and fear of emotional reactions before and after transplant surgery. The fear of transplant surgery for patients and their families is involved. Physical and psychological aspects. According to the analysis of the Health Insurance Bureau, the number of liver transplants in China has shown an upward trend. There were 418 cases from 2001 to 2004, 978 cases from 2005 to 2008, and 1227 cases from 2009 to 2011. Under this trend, patients and their families are concerned with the quality of medical services. The expectations are even more ardent. Compared with the doctor-led medical process in the past, medical institutions face a highly competitive business environment. In the case of patients with more choices, hospital survival competition must think about how to turn to improve the quality of medical services, and get patients to seek medical treatment again. Willingness to achieve the goal of sustainable hospital management.
SERVQUAL divides service quality into five levels: Tangibles, Reliability, Responsiveness, Assurance, and Empathy. Each level is subdivided into several issues. Through questionnaires, users are asked to rate the expected value, actual perceived value and the lowest acceptable value of each question. It is illustrated by the 22 specific factors that establish it. Then, through the questionnaire survey, customer scoring and comprehensive calculation, the score of service quality is obtained. In the past decade, this model has been widely accepted and adopted by managers and scholars. The model is based on the theory of difference, the difference between the customer's expectation of service quality and the customer's actual service from the service organization. The model uses five scales to evaluate the quality of service of different services accepted by customers. Studies have shown that SERVQUAL is suitable for measuring the quality of service of message systems.
SERVQUAL is also an effective tool for evaluating service quality and for determining actions to improve service quality. For decades, the development of communication technology and information has made great progress. Business transactions have also changed from the traditional face-to-face interaction model to the transmission and circulation of information through the Internet, and consumers are increasingly paying attention to information quality.
In this study, the service quality defined by three scholars, Parasuraman, Zeithhaml and Berry, is the main research axis to explore whether the quality of the relationship between doctors and patients can be improved through the network service platform. Service quality includes tangibility, reliability, responsiveness, assurance, and care. The researchers first conducted qualitative interviews and then measured the medical service experience of the samples by questionnaire. The study sample was a liver transplant patient in a large hospital in Taichung. The total effective sample was 117, and the effective questionnaire recovery rate was 75%. Regression for hypothesis verification. The results of the study showed that after the information platform was set up, the quality of patient care information was greatly improved, and the patient loyalty was also significantly improved. However, the patient's feelings about tangibility and responsiveness were declining.

目 錄
摘要……………………………………………………………………………………..ⅰ
Abstract………………………………………………………………………………….ⅰⅰ
目錄………………………………………………………………………………………iv
表目錄………………………………………………………………………………….. vi
圖目錄………………………………………………………………………………….. vii
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……………………………………………………………….3
第二章 文獻探討 ………………………………………………………………………..4
第一節 服務品質……………………………………………………………….4
第二節 醫病關係連結………………………………………………………….5
第三節 病患照護資訊品質……………………………………………………………….5
第四節 顧客滿意度…………………………………………………………….5
第五節 顧客忠誠度…………………………………………………………….8
第三章 研究方法…………………………………………………………...11
第一節 研究架構………………………………………………………………11
第二節 研究變數及其操作性定義……………………………………………12
第三節 研究對象與調查方法…………………………………………………13
第四節 研究過程………………………………………………………………13
第四章 實證結果與分析…………………………………………………15
第一節 樣本結構分析………………………………………………………….15
第二節 描述性統計分析……………………………………………………….16
第三節 信效度分析…………………………………………………………….16
第四節 迴歸分析與假設檢定………………………………………………….18
第五節 前後測差異檢定……………………………………………………….20
第五章 結論與建議……………………………………………….22
第一節 研究結論與管理意涵………………………………………………….22
第二節 未來研究建議………………………………………………………….22
參考文獻……………………………………………………………24
附錄 訪談逐字稿………………………………………………………27
附錄 受訪個案索引……………………………………………………45
附錄 逐字稿內容整理……………………………………………...….46
附錄 研究問卷……………………………………………...………….49
附錄 網路平台………………………………………………………....53


表目錄
表1. 變數及其操作性定義…………………………………………………12
表2. 人口統計變項統計表…………………………………………………15
表3. 信效度分析……………………………………………………………17
表4. 滿意度迴歸分析………………………………………………………19
表5. 忠誠度迴歸分析………………………………………………………19
表6. 前後測差異檢定………………………………………………………20
表7. 假說結果彙整…………………………………………………………21

圖目錄
圖1.研究流程圖………………………………………………………………….3
圖2.顧客忠誠分類……………………………………………………………….9
圖3.研究架構……………………………………………………………………11

參考文獻
一、中文文獻
呂鴻德、賴宏誌、謝憶文（2000）。顧客滿意構面、品牌忠誠度與顧客終身價值關係之研究：LISREL模式之實證。中原學報，28（4），25-36。
鄭博宇（2003）。台北市咖啡連鎖店服務品質管理與顧客滿意度之個案研究。未出版碩士論文，中國文化大學，台北市。
石曜堂（2006）。從全面品質管理觀點談醫療品質的提升與醫病關係的建構，源遠季刊，第十七期，14-16。
鄭凱若（2006）。運用結構方程模式探討產品品質、服務品質、顧客滿意度、商店形象與顧客忠誠度之關係-以咖啡連鎖店為例，未出版碩士論文，國立東華大學，花蓮。
張冀剛（2008）。企業形象與消費者購買行為、忠誠度及滿意度之關係探討-以台灣速食產業龍頭麥當勞為例。未出版碩士論文，成功大學，台南市。
楊聖傑（2018）。可重複使用嬰兒布尿褲購買意願之研究。碩士論文，國立中興大學，台中市。
二、英文文獻
Bloemer, J. M., & Kasper, H.D.P. (1995). The complex relationship between consumer satisfaction and brand loyalty. Journal of Economic Psychology, 16(2), 311-329.

Berry, L. L., 1983, Relationship Marketing, in Berry, L. L., Shostack, G.L., and Upah, G.D. (Eds.), Emerging Perspectives of Services Marketing, 25-28. Chicago, IL:American Marketing Association.

Berry , L. L. and Parasuraman, A., 1991, Marketing Services ：Competing through Quality, New York, NY:The Free Press.

Bitner, M. J., 1995, Building Service Relationships：It’s all about Promises, Journal of the Academy of Marketing Science, 23(4), 246-251.

Braunstein, J.J. (1981). Communication between the physician and the patient, medical application of the behavior science. Chicago, IL：Yearbook Medical.

Cardozo, R. N. (1965). An experiment study of customer effort, expectation, and satisfaction. Journal of Marketing Research, 2(3), 244-249.

Day, G. S. and Wensley, R., 1983, Marketing Theory with a Strategic Orientation, Journal of Marketing, 47(4), 79-89.

DeLone WH, McLean ER：Information systems success ：The quest for the dependent variable. Information Systems Research 1992；3：60-95.

Fornell, C. (1992). A National Customer Satisfaction Barometer ：The Swedish Experience, Journal of Marketing, 56(1), 6-21.

Gronroos C：A service quality model and its marketing implications. European Journal of Marketing 1984；18：36-44.

Garbarino, E., & Johnson, M. S. (1999). The different roles of satisfaction, trust, and commitment in customer relationships. Journal of Marketing, 63(2), 70-87.

Hwang, P. (2005). Managing Relational Bond ：An integrative Approach, Journal of Business, 78(2), 557-576.

McCall, G. J. (1970). The Social Organization of Relationships, in McCall, G. j., McCall, M. M., Denzin, N.K., Suttles, G.D., and Kurth, S. B. (Eds.), Social Relationships, 3-34, Chicago, IL：Aldine Publishing Company.

Oliver RL, Macmillan J. Response Determinants in Satisfaction Judgements. Journal of Consumer Research 1992；14：495-507.

Parasuraman A, Zeithaml VA, Berry LL：SERVQUAL –a multiple-item scale for measuring consumer perceptions of service quality. Journal of Retailing 1988；64：12-40.

Parasuraman A, Zeithaml VA, Berry LL：A conceptual model of service quality and its implications for future research. Journal of Marketing 1985；49：41-50.

Pizam, A., & Ellis, T. (1999). Customer satisfaction and its measurement in hospitality enterprises. International Journal of Contemporary Hospitality Management, 11(7), 326-339.

Szasz, T. S., & Hollender, M. H. (1956). The basic models of the doctor-patient relationship. Archive Internal Medicine, 97(5), 585-592.




Solomon , M. R., Surprenant, C., Czepiel, J. A., and Gutman, E. G. (1985). A Role Theory Perspective on Dyadic Interactions：The Service Encounter, Journal of Marketing, 49(1), 99-111.

Turner, R. H. (1970). Family Interaction, New York, NY：John Wiley and Sons, Inc.

Wixom HB, Todd AP：A theoretical integration of user satisfaction and technology acceptance. Information Systems Research 2005；16：85-102.

Wilson, D. T. (1995). An integrated Model of Buyer-Seller Relationships, Journal of the Academy of Marketing Science, 23(4), 335-345.

Yi, Y. (1990). A critical review of consumer satisfaction. In V. A. Zeithaml (Ed.) Review of marketing (68-123), Chicago：American Marketing Association.

Zeithaml, V. A. Berry, L. L., and Parasuraman, A. (1996). The Behavioral Consequences of Service Quality, Journal of Marketing, 60(2), 31-46.

Zins, A. H. (2001). Relative attitudes and commitment in customer loyalty models：Some experiences in the commercial airline industry. International Journal of Service Industry Management, 12(3), 269-294.