醫療品質、知覺價值、病患滿意度與忠誠度之相關性探討－－以中部某區域醫院門診病患及其親屬為例

A Study on the Relationship among Healthcare Quality, Perceived Value, Patient Satisfaction and Loyalty in a Regional Hospital's Outpatients and their Relatives in Central Taiwan

目的：以醫院門診病患及其親屬的角度，探討醫療品質、知覺價值、病患滿意度與忠誠度之關聯性。方法：本研究採橫斷面調查法、立意抽樣，以結構式問卷針對20歲以上中部某區域醫院門診病患及其親屬且自願參與者進行問卷調查。期間為自2014年4月至2014年5月，總共發放500份問卷，有效問卷回收448份（89.60%）。統計方法應用結構方程模式考驗各測量模式及結構模式，其中以知覺價值、病患滿意度為中介變項。結果：本研究以內科門診（135位，佔30.13%）、男性（237位，佔52.90%）、26-35歲（181位，佔40.40%）者居多。測量變項及潛在變項均具有良好的信效度，且因果模式符合基本適配指標。醫療品質（直接效果=0.18）、知覺價值（直接效果=0.30）兩者對忠誠度皆具有正向的影響，且醫療品質可透過知覺價值（間接效果=0.35）、病患滿意度（間接效果=0.44）兩者的中介效果影響忠誠度；病患滿意度是知覺價值對忠誠度最重要的中介變項，意即知覺價值是影響病患滿意度重要因素（直接效果=0.63），而病患滿意度同時也是病患忠誠度的重要因素之一（直接效果=0.58）。結論：醫院的醫療品質要做得好，就會提升門診病患對醫院的知覺價值及提高病患滿意度，進而會影響門診病患的忠誠度。

Objectives. The purpose of this study was to identify the relationship between the healthcare quality, perceived value, patient satisfaction and loyalty from the viewpoint in a hospital's outpatients and their relatives. Methods. This study used a cross-sectional survey with purposive sampling to select a regional hospital's outpatients and their relatives 20 years old or above from Apr. through May 2014. We collected 448 valid questionnaires out of 500 with a response rate of 89.60%. Structural equation modeling (SEM) was used to analyze test measurement and structural model. Perceived value and patient satisfaction were used as mediating variables. Results. Most of the participants were making internal medicine visits (135, 30.13%), were male (237, 52.90%) and ranged from 26-35 years old (181, 40.40%). All the measurements and potential variables in this study were interpreted and supported with adequate levels of reliability and validity. The model design performed in our study was satisfied by the preliminary fit criteria. We found a significant positive relationship between healthcare quality, perceived value and loyalty. Perceived value and satisfaction mediated the relationship between the healthcare quality and loyalty. Our study also showed that perceived value had a significantly positive impact on loyalty, and this impact was intensified via the mediator of satisfaction, meaning that perceived value was the most important factor affecting satisfaction. Moreover, satisfaction was one of the most important factors affecting loyalty. Conclusion. Our study showed that high level healthcare quality helps upgrade perceived value and satisfaction, which in turn leads to greater loyalty.