醫院經營自費醫療服務之實證研究

An Empirical Study of Self-pay Services in the Hospital

本研究鑑於自費醫療服務為醫院永續經營的重點之一，有必要掌握自費醫療服務品質的內涵與消費者獲得自費醫療服務資訊的方式。因此，本研究以新北市某醫學中心為研究個案，在以顧客為導向的基礎上，分析自費醫療項目的服務品質需求與資訊公開方式，以作為醫院經營自費醫療服務的參考。主要發現為：消費者在選擇自費醫療服務時，優先考慮因素為「醫療服務的效果」；其次是「醫師的專業能力」；其他的意見如「新的儀器設備」、「病快好」、「等候時間短」等。八成受訪的消費者表示滿意個案醫院的自費醫療服務，表示不滿意的原因為「等候時間長」、「停車不方便」、「價格偏高」等。消費者獲得個案醫院自費服務之資訊管道，主要為「親友同事介紹」、「醫院的網站」、「醫院服務人員」等，顯示民眾獲得自費醫療服務的資訊仍以有經驗者的親友意見為優先，其次是透過醫院網站、院內醫務人員。此外，本研究訪談醫療服務供給者亦認為自費醫療服務的「口碑」十分重要，亦即在醫療服務不得行銷的限制下，民眾選擇自費醫療服務仍以有經驗的親友為意見來源，此一發現在消費者問卷調查亦獲得印證。同時訪談的醫療服務供給者認為民眾選擇自費醫療服務最重視的醫療效果，此一觀點亦與消費者的意見一致。研究發現醫院經營自費服務時，仍應以醫療專業為基礎，獲得消費者肯定，並善用資訊科技，藉由個人化資訊傳遞，擴大服務數量。

Since the national health insurance program was implemented on 1996, the medical environment of Taiwan has been dramatically changed with increasing competition among hospitals. The importance of self-pay services for the hospitals is increasing. Therefore, this study utilizes a medical center as a case study to analyze the factors of self-pay services from customer-oriented perspectives. The research methods include literature analysis, in-depth interview, and survey research. The model of this study is based on the”structure-process-outcome' theorem of Donabedian and indicators of the research hospital. The major findings are that customers of self-pay services consider professional ability of physicians and medical outcomes as the priorities of choosing hospitals' services. Also, eighty percent of customers expressed their satisfaction with their self-pay medical services in the target hospital. The sources of information about self-pay services are the introduction from co-workers and friends, website of the hospitals, and staff of hospitals. Since health care institutes have marketing restrictions from the government, customers consider the experienced friends and relatives as sources of advice. The research present some recommendations that the hospital management services should focus on professional image of the medical profession, based on access to consumer recognition and use of information technology to expand the amounts of self-pay services.