病患對服務品質與滿意度之策略性研究－－以某醫學中心為例

A Strategic Study on Service Performance Quality and Patient’s Satisfaction in a Medical Center

研究醫院自民國78年開始，每年定期進行病患滿意度調查，由於長期以來發現滿意度較低的服務項目，未必是急需改善之項目，致使改善追蹤的工作沒有著力點，因此，自89年起問卷內容增加病患對各問項重視程度的瞭解。本研究主要依91年度財團法人醫院評鑑暨醫療品質策進會所採用之新制，對四家醫學中心試評時，醫管組之評鑑項目及其評分指標，發展成結構式問卷，採橫斷面調查法，於91年9月初對研究醫院門診病患進行實證研究，以受訪者自填方式蒐集所需的資料，發出問卷1,459份，回收有效問卷681份，回收率為46.68%，整體信度達0.99，各構面信度介於0.88至0.96之間，資料經迴歸分析及滿意策略架構等方法分析後發現：研究醫院在方便性、完整性、參與性三個構面內之問項，大部份處於競爭優勢（高期望高評價），而適切性之問項則大部份處於競爭劣勢（高期望低評價）；本研究實證結果發現，以患者為醫療品質評估者時，採用績效與期望差距之滿意評量模式，可找到急需改善的服務項目而不是評價較低的項目，本研究分析結果，43個問項中處於競爭劣勢之服務項目有六項，而需優先改善者則有兩項，可見本研究之整合分析方式，可將需要改善的服務項目歸納到最簡，同時可排出優先順序，對醫院提昇服務品質時擬定重點式管理方向，可提供較確定之資訊。

The sample frame is a medical center located in Northern Taiwan, A survey on its patients' satisfaction has been givers every year since 1989. After a long term of observation, it is found that the major factors must be altered and the results of those surveys were not appropriate. Therefore, starting from the year of 2000, a new dimension, patients' expectation, was added in the questionnaire, This study provides the gap between the service performance and the patients' expectation, the major factors and their priority, which effect the satisfaction of the sample frame. Following this measured pattern, the data of this study were collected via the structured questionnaires based ort the standards of grading tire pilot test by the Taiwan joint Commission Hospital Accreditation of Medical Center in September 2002. In this study, 1,459 questionnaires were issued and 681 valid ones were retrieved. The response rate is 46.68%, total reliability is up to 0.99, and the reliability of each dimension is between 0.88 and 0.96. Major research findings after analysis by stepwise regression and the Strategic Framework for Satisfaction are as follows: Most indices of accessibility, participatory and integrality are of competitive strength (high expectation and high performance), conversely most indices of appropriate are of competitive vulnerability (high expectation but low performance). 'This study also found out that in view of patients' evaluation on the quality of hospital care, among the customer's satisfaction measurement models, the gap between the performance and the expectation has provided more information for the administrators. Therefore, this measurement, model finds the idealized service items not only those underestimated but also those need to be improved and their priority.