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    Title: 中醫診所醫療服務品質與回診意願之研究
    A study on service quality and retreatment intentions for traditional chinese medical clinics
    Authors: 張庭嘉
    Chang, Ting Chia
    Contributors: 高安邦

    張庭嘉
    Chang, Ting Chia
    Keywords: 中醫診所
    醫療服務品質
    滿意度
    回診意願
    Date: 2010
    Issue Date: 2013-09-03 16:06:55 (UTC+8)
    Abstract:   目前台灣中醫以門診為主,雖有部分醫院經營住院部門,但由於現階段全民健保尚未將「中醫住院」納入為給付範圍,導致中醫住院的病患必須全部自費,所以利用率偏低,因此中醫的主要業務仍在診所部分。1995年至2010年的統計數據發現,中醫診所有急遽增加的趨勢,加上中醫師人口成長幅度過快及中藥材成本上升,使中醫診所面臨激烈競爭,而如何有效提升醫療服務品質與病患回診意願,將是診所經營者當務之急。
      本研究參考蔡文正等人(2008)運用PZB(Parasuraman, Zeithaml and Berry)SVERQUAL量表所建立之中醫醫療服務品質評估指標,衡量模式的五個構面,分別是有形性、可靠性、回應性、保證性及關懷性,並根據回診意願之相關文獻,發展出病患回診意願之評估指標,藉由問卷調查,以新北市五家中醫診所病患為研究對象,探討病患對於中醫診所提供之醫療服務品質的重視情形、實際接受服務後的滿度程度及回診意願的影響。
      研究結果顯示中醫診所病患對於醫療服務品質的實際感受較本身所期望之服務有落差,不同特性之病患對於醫療服務品質的重視程度與滿意程度、回診意願也有差異情形;由相關分析與迴歸分析得知,醫療服務品質重視程度和滿意程度,與回診意願皆有顯著的正相關存在,且以醫療服務品質的「回應性」、「保證性」及「關懷性」三個層面的滿意程度,對「回診意願」有較高預測力。故未來中醫診所針對回診意願之提升,應以此為主要策略目標;同時,對於滿意程度較高之指標應強化、保持,在增進病患回診意願上必有所助益,俾使民眾擁有更優質之醫療環境。
    Reference: 一、中文部分
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    李金鳳(1990),《中西醫門診病患對傳統醫療認知情意與行為意向之調查研究》。台北:國立陽明醫學院公共衛生研究所碩士論文。
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    蔡文正(2005),《應用服務品質缺口理論建立與評估中醫醫療服務品質指標》。台中:中國醫藥大學醫務管理學系暨碩士班碩士論文。
    蔡文正、龔佩珍、翁瑞宏、張永賢、李思儀(2008),「應用SERVQUAL量表建構中醫醫療服務品質指標」,《台灣衛誌》,27(4),頁309-319。
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    鄧振華(2002),《台灣地區中醫醫療資源及病患特質對中醫醫療服務利用之研究》。台中:中國醫藥學院碩士論文。
    盧安琪(2002),《國立成功大學醫學中心門診醫療服務品質之實證研究》。台南:國立成功大學企業管理研究所碩士論文。
    羅紀瓊(1991),「勞保中醫利用」。台北:行政院衛生署委託研究報告。
    謝月貞(2010),《應用服務品質缺口理論探討門診檢驗服務品質》。雲林:國立雲林科技大學健康產業管理研究所碩士論文。
    嚴秀娟(2010),《醫護人員及就醫民眾對中醫醫療服務品質期望與滿意度之探討-以高屏地區中醫醫療院所為例》。高雄:高雄醫學大學健康科學院醫務管理學研究所碩士在職專班碩士論文。

    二、英文部分
    Anderson, Eugune W. and Sullivan, Mary W. (1993), “The Antecedents and Consequences of Customer Satisfaction for Firms.” Marketing Science, 12, 125-143.
    Astin J. A. (1998), “Why Patients Use Alternative Medicine: Results of a National Study.” Journal of American Medicine Association, 279 (19), 1548-1553.
    Bryman, A. and Duncan C. (1997), Quantitative Data Analysis with SPSS for Windows: A Guide for Social Scientists. London; New York: Routledge.
    Charska, N. L. (1980), “Use of Medical Service and Satisfaction with Ambulatory Care among a Rural Minnesota Population.” Publish Health Report, 95, 44-52.
    Chaudhuri, A. and Holbrook, M. B. (2001), “The Chain of Effects from Brand Trust and Brand Affect to Brand Performance: The Role of Brand Loyalty.” Journal of Marketing, 65 (2), 81-93.
    Dick, A. and Basu, K. (1994), “Customer Loyalty: Toward an Integrated Conceptual Framework.” Journal of the Academy of Marketing Science, 22 (2), 99-113.
    Donabedian, A. (1966), “ Evaluation the Quality of Medical Care,” Milbank Memorial Fund Quarterly, 44, 166-203.
    Donabedian, A. (1978), “The Quality of Medical Care.” Science, 200 (4344), 856-864.
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    Donabedian, A. (1989), “ The Quality of Medical Care: How can it be Assessed ? ” Journal of American Medical Association, 260 (12), 1743-1750.
    Eisenberg, D. M., Davis, R. B., Ettner, S. L., Appel, S., Wilkey, S., Rompay, M. V. and Kessier, R. C. (1998), “Trends in Alternative Medicine Use in the United States, 1990-1997: Result of a Follow-Up National Survey.” Journal of American Medicine Association, 280 (18), 1569-1577.
    Folkes, V. S. (1988), “Recent Attribution Research in Consumer Behavior: A Review and New Directions.” Journal of Consumer Research, 14, 548-565.
    Guilford, J. P. (1965), Fundamental Statistics in Psychology and Education, 4th Edition. New York: McGraw-Hill.
    Jones, T. O. and Sasser, W. E. (1995), “Why Satisfied Customers Defect.” Harvard Business Review, 37 (6), 88-99.
    Kotler, P. (1994), Market Management: Analysis, Planning, Implementation, and control. NewYork: Prentice-Hall.
    Kotler, P. (2000), Marketing Management, 10th Edition. New Jersey: Prentice-Hall.
    McAlexander, Kaldenberg and Koening (1994), “Service Quality Measurement.” Journal of Health Care Marketing, 14, 491-504.
    Mittal, V. and Kamakura, W. A. (2001), “Satisfaction, Repurchase intent and Repurchase Behavior: Investigating the Moderating Effect of Customer Characteristics.” Journal of Marketing Research, 38 (1), 131-142.
    Nunnally, J. (1978), Psychometric Theory, 2nd Edition. New York: McGraw-Hill.
    O`Connor J. S., Richard, M. S. and Bowers, M. R.(1991), “A Model of Service Quality Perceptions and Health Care Consumer Behavior.” Journal of Hospital Marketing, 6 (1), 62-69.
    Olive, R. L. (1980), “A Cognitive Model of the Antecedents and Consequences of Satisfaction Decisions.” Journal of Marketing Research, 17, 460-469.
    Oliver, R. L. (1981), “Measurement and Evaluation of Satisfaction Processes in Retail Settings.” Journal of Retailing, 57 (3), 25-48.
    Olive, R. L. (1997), Satisfaction: A Behavioral Perspective on the Consumer. Boston: McGraw-Hill.
    Parasuraman, A., Zeithaml, V. A. and Berry, L. L. (1985), “A Conceptual Model of Service Quality and Its Implication for Future Research.” Journal of Marketing, 49 (4), 41-50.
    Parasuraman, A., Zeithaml, V. A. and Berry, L. L. (1988), “SERVQUAL: A Multiple-item Scale for Measuring Consumer Perceptions of Service Quality.” Journal of Retailing, 64, 13-40.
    Parasuraman, A., Zeithaml, V. A. and Berry, L. L. (1994), “Reassessment of Expectations as a Comparison Standard in Measuring Service Quality: Implications for future Research.” Journal of Marketing, 58 (1), 111-124.
    Parasuraman, A., Zeithaml, V. A. and Berry, L. L. (1996), “The Behavioral Consequences of Service Quality.” Journal of Marketing, 60 (2), 31-47.
    Risser, N. (1975), “Development of an Instrument to Measure Patient Satisfaction with Nurses and Nursing Care Primary Care Settings.” Nursing Research, 24, 45-52.
    Roberts. K., Varki, S. and Brodie, R. (2003), “Measuring the Quality of Relationships in Consumer Services: An Empirical Study.” European Journal of Marketing, 37 (1/2), 169-196.
    Rust, R. T., Inman J., Jia, J. and Zahorik A. (1999), “What You Don’t Know About Customer Perceived Quality: The Role of Customer Expectation Distributions.” Marketing Science, 18 (1), 77-92.
    Schwartz, J. S. (1994), “Measuring Quality: Where Are We? Where Are We Going? And How Will We Know When We Get There? ” Annals New York Academy of Sciences, 150-74.
    Singh, J. and Sirdeshmukh, D. (2000), “Agency and Trust Mechanisms in Consumer Satisfaction and Loyalty Judgments.” Journal of the Academy of Marketing Science, 28 (1), 150-167.
    Taylor, S. A. and Baker, T. L. (1994) “An Assessment of Relationship Between Service Quality and Customer Satisfaction in the Formation of Consumer’s Purchase.” Journal of Retailing, 70, 163-178.
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    三、相關網頁
    行政院衛生署網頁: http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=11468&level_no=1&doc_no=77184
    行政院衛生署中醫藥委員會中醫藥資訊網網頁:http://www.ccmp.gov.tw/public/public.asp?selno=762&relno=762&level=C
    Description: 碩士
    國立政治大學
    行政管理碩士學程
    98921023
    99
    Source URI: http://thesis.lib.nccu.edu.tw/record/#G0098921023
    Data Type: thesis
    Appears in Collections:[Master for Eminent Public Administrators] Theses

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