以SERVQUAL與重要性績效分析(IPA)探討某區域醫院產婦生產服務品質

The Quality of Childbirth Services in a Regional Hospital: Application of SERVQUAL and Importance Performance Analysis (IPA)

目的：
在少子化的社會中，台灣婦女生育率逐年降低，不但讓整個醫療市場競爭激烈，也讓醫療院所極為重視服務品質的議題。本研究以SERVQUAL與IPA兩種方法探討產婦對生產服務品質的看法。
方法：
本研究採用自填式問卷，內容為根據相關文獻擬訂之修正SERVQUAL量表，分別詢問受訪者對生產服務品質項目之期望與知覺。研究對象為346位中部某區域醫院生產之產婦。以SERVQUAL與IPA分別探討其服務品質，其中SERVQUAL根據定義式計算缺口（知覺－期望），IPA則分別以重要性與滿意度之整體平均值為基礎區分四個象限。
結果：
服務品質可區分成有形環境、行政管理、醫師照護、護理照護、人員服務、嬰兒照護等六個服務品質構面。整體重要性（期望）、滿意度（知覺）與缺口之平均值分別為4.75、4.66與-0.09。在SERVQUAL中，重複量數變異數分析結果指出，有形環境是期望最低（4.64）、知覺最低（4.42）與缺口最大（-0.21）的構面；其中缺口最大的前五項均為有形環境與行政管理構面。以IPA進行探討發現，落在優先改善區的二個項目均屬於有形環境構面之項目。
結論：
產婦對醫院的硬體環境與服務流程的評價能力明顯優於專業服務品質，因此除提升醫療、護理專業的技術水準外，醫院仍應致力於環境與服務流程的改善，因為這是產婦最容易看到、最容易評斷、也最不容易滿足之處。

Purposes:
As Taiwan’s fertility rate continues to decline, the healthcare market is becoming increasingly competitive. Healthcare institutions are thus intensifying their focus on service quality. This study employed SERVQUAL and Importance Performance Analysis (IPA) methods to investigate maternity patients’perceptions of the quality of childbirth services.
Methods:
This study utilized aself-administered questionnaire scored on amodified SERVQUAL scale developed from relevant literature that inquired about maternity patients’expectations and perceptions regarding aspects of childbirth service quality. This survey included 346 maternity patients who were admitted to aregional hospital in central Taiwan. The quality of childbirth services was analyzed using SERVQUAL and IPA. SERVQUAL was employed to calculate the gap between perception and expectations with adefinitional formula (perception-expectation), while IPA was employed to categorize service quality into four quadrants based on means of overall importance and satisfaction.
Results:
We found that childbirth service quality can be divided into six dimensions: tangible environment, administrative management, physician care, nursing care, supporting personnel services, and infant care. The overall means for importance (expectation), satisfaction (perception), and gap were 4.75, 4.66, and -0.09, respectively. Repeated measured analysis of variance revealed that tangible environment expectation (4.64), and perception (4.42) scored the lowest and yielded the highest gap (-0.21) in SERVQUAL. The items associated with the top five gap values were all related to tangible environment and administrative management. In the IPA investigation, the two items in the priority improvement quadrant were both components of tangible environment.
Conclusions:
The study findings indicate that maternity patients are more capable of evaluating tangible environment and service processes than quality of professional services, indicating that healthcare institutions should prioritize improving these aspects of the patient experience, along with enhancing the skills of physicians and nurses. Maternity patients are most likely to observe and evaluate hospital environment and administrative processes, and it can be challenging to meet their expectations in these areas.