探討急診顧客滿意度變動趨勢及其影響因素

Exploring the Trends and Associated Factors of Customer Satisfaction in an Emergency Department

背景：台灣地區急診就診人次逐年增高，平均約佔醫院住院病人 50%，連帶效益佔全院總收入一半以上，用來測量醫院績效重要指標。

目的：探討影響關鍵指標的前因變數，五年來急診顧客滿意度之變化趨勢。

方法：以立意取樣調查南部某區域醫院急診就診之病人或家屬，5年急診服務滿意度。

結果：五年之急診顧客滿意度之變化趨勢，服務結果對於急診顧客滿意度具有最高的影響力，均會對病人滿意度產生影響，而「等待時間」並非是影響病人滿意度的絕對因素，僅有「醫療過程」、「服務結果」對於「病人滿意度」的影響力最高，每年均達顯著；地緣性方面其病人位於東區仍較多，但仍有一些是遠從他區到東區求診，推測對院的忠誠度及信任感高於他們當地醫院，其整體還是處於滿意居多。也發現 2014 年是醫院新制評鑑，不管在人力及各方面品質要求都必須俱備完善，當然也包括相關服務禮儀或環境設施之要求。

結論：由趨勢圖發現，其 2011 年顧客滿意度是五年中分數最低的，檢視過去離職率資料，發現 2011 年之離職率高達 27.8% 是五年中最高的，也吻合文獻中所提到護理人力不足與住院病人的感染率、死亡率、跌倒、壓瘡以及病人和家屬的滿意度有相關性。在現今護理人力短缺及招募護理人力困難之下，如何提升醫療品質及顧客滿意度，正是考驗醫院的經營管理決策，這也是我們值得深思的一門課題。

The number of emergency department (ED) visits has markedly increased in Taiwanese hospitals in recent years. The associated income of ED visits often accounts for more than half of the annual income of a hospital. Therefore, customer satisfaction with healthcare services provided in emergency departments has become a vital indicator of hospital operation. The survey was carried out from September 2011 to March 2015. The research tool was developed based on the Taiwan Healthcare Indicator Series (THIS), and is divided into five parts consisting of 50 questions. A total of 795 customer satisfaction questionnaires were included in this survey. The survey discussed the trends of ED customer satisfaction from 2011 to 2015 and proposed five variables of satisfaction and their correlations. ED customer satisfaction levels in 2012, 2014, and 2015 were above the overall mean score. Gender, age, educational level, place of residence, department visited, and time period of the visit to the ED influenced hospital facilities, waiting time of patients, staff’s attitude, medical processes and consequences of service, which were all variables of customer satisfaction. From the 5-year trend curve, medical procedures and consequences of service had positive impacts on customer satisfaction and consequences of service showed a stronger influence than medical procedures. Moreover, manpower deployment was also regarded as an influential indicator of satisfaction