博碩士論文 etd-0706116-175948 詳細資訊


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姓名 宋貞蓉(Chen-Jung Sung) 電子郵件信箱 E-mail 資料不公開
畢業系所 高階經營碩士班(EMBA)
畢業學位 碩士(Master) 畢業時期 104學年第2學期
論文名稱(中) 基層醫療院所滿意度分析之研究-以骨外科病人為例
論文名稱(英) A Study of Patient-Reported Satisfaction Toward the Services of Primary Clinics-Using Orthopedic Patients as Examples
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    摘要(中) 本研究主要探討基層醫療院所滿意度分析,以個案骨外科診所門診及復健病患為抽樣問卷對象,進行問卷調查,並透過比較各種就醫滿意度因素,來得知個案診所病患滿意度因素,並進一步將不同屬性病患與就醫滿意度加以比較,可提供基層醫療院所(含個案骨外科診所)作為經營策略上之參考。病人滿意度在近幾年已發展為多面向的結構;這意謂著病患可能對某一構面有相當高度的滿意度,但對其他的的構面則未必,甚至可能是很低的滿意度(Susan & Robert,1999)。對醫療產業而言,病患滿意度可視為衡量醫療品質的重要評估指標(Donabedian, 1996)。而現今醫院所採用的醫療服務品質衡量構面大多都是以Donabedian(1988)所提的『結構-過程-結果』三構面來衡量醫療服務品質。
    本研究透過個案骨科診所進行問卷調查,對病患就醫滿意度因素進行研究,以平均值排序及成對樣本T檢定得出以下結果:依診所結構面而言,病患滿意度前五名依序為診療器具、醫師醫術、環境清潔、復健儀器、和復健師復健技術;滿意度最低的兩名為外觀和認識診所的人。依過程面而言,病患滿意度前五名依序為醫師仔細解說病症、 可以與醫師相互談論病情,醫師都會專注聆聽、醫師會提供所有可能的醫療檢查或檢測,以及醫師和復健師很清楚的解釋治療與用藥、復健的目的;滿意度最低的兩名為復健等候時間合宜和門診等候時間合宜。依結果面而言,病患滿意度前五名依序為復健後疼痛已有明顯改善、看病後病情已有明顯改善、復健後對於肌力已有明顯改善、復健後對於肢體關節活動已有明顯改善,以及就醫及諮詢方便性佳;滿意度最低的兩名為醫療費用和復健費用。
    本研究進一步依病患人口統計變項及就醫背景,使用獨立樣本T檢定及變異數分析,探討就醫滿意度因素,依診所就醫滿意度結構面而言,在性別、年齡、婚姻狀況、教育程度和家庭年收入有部份問項有顯著差異;在就醫背景方面,則初複診、就醫來源、交通工具和交通時間有部份問項有顯著差異。依診所就醫滿意度過程面而言,在年齡、婚姻狀況、教育程度、職業和家庭年收入有部份問項有顯著差異;在就醫背景方面,交通工具、交通時間有部份問項有顯著差異。依診所就醫滿意度結果面而言,在職業有部份問項有顯著差異;在就醫背景方面,在交通工具有部份問項有顯著差異。
    摘要(英) For medical industry purposes, patient satisfaction can patient-reported satisfaction toward the services of primary clinics, with special focus on orthopedic patients. Questionnaire are issued to orthopedic patients of a target orthopedic clinic. Through comparison of various physician satisfaction factors, we hope to identify the critical clinic patient satisfaction factors. The results are expected to provide primary health care institutions with directions for their business strategy planning.
    Patient satisfaction in recent years has developed into a multifaceted structure. For medical service quality evaluation and research methods, we follow the satisfaction model proposed by Donabedian (1988) and focus on three facets, namely process, structure, and outcome.
    We report the result of orthopedic medical care satisfaction factors by employing average values and paired sample T test. In the structure facet, the top five factors of patient satisfaction are medical equipment, medicine physician, clean environment, rehabilitation equipment, and rehabilitation division rehabilitation technology, whereas clinic appearance and acquaintance of clinics people are among the lowest patient satisfaction. In the process facet, the top five factors of patient satisfaction are the detailed explanation of patients’ condition, well interaction with the physician on the discussion of patients’ disease, physician’s attention on patients, supply of all possible medical examinations or tests, and detailed explanation of treatment, medication, and rehabilitation purposes, while rehabilitation waiting time and outpatient waiting time top the list of dissatisfaction factors. In the outcome facet, the top five satisfaction factors are pain relief after rehabilitation, symptom reduction after treatment, muscle strength improvement after rehabilitation, limb and joint activities improvement after rehabilitation, and convenience of medical care and counseling, with medical expenses and rehabilitation costs being the two lowest satisfaction factors.
    This research also conduct independent sample T test and analysis of variance to compare the dependence between demographic variables/background of patients and medical care satisfaction factors. We find that in the structure facet, gender, age, marital status, education level, household income, first or second visit, medical sources, transportation, and travel time have significant differences. In the process facet, age, marital status, education level, occupation, household income, transportation, travel time, these questionnaire items have significant differences. Finally, in the outcome facet, occupation, background, and transportation have significant differences.
    關鍵字(中)
  • 病人滿意度
  • 醫療服務
  • 醫療品質
  • 基層診所
  • 骨外科診所
  • 關鍵字(英)
  • Quality of care
  • Patient-reported satisfaction
  • Orthopedic Clinics
  • Primary clinics
  • medical service
  • 論文目次 論文審定書 i
    誌 謝 ii
    中文摘要 iii
    英文摘要 iv
    目 錄 v
    圖 次 vi
    表 次 vii
    第一章 緒論 1
    第一節 研究背景與動機 1
    第二節 研究目的 3
    第三節 研究流程 3
    第四節 研究架構 5
    第二章 文獻探討 6
    第一節 醫療服務業方面 6
    第二節 醫療滿意度相關文獻 8
    第三章 研究設計 12
    第一節 研究架構 12
    第二節 變數之操作性定義與衡量 12
    第三節 問卷設計 14
    第四節 抽樣設計 15
    第五節 資料分析方法 15
    第四章 實證結果分析 17
    第一節 樣本資料分析 17
    第二節 診所各構面因素之萃取與信度分析 22
    第三節 就醫滿意度各構面差異分析 25
    第四節 病患特性於診所就醫滿意度各構面之差異分析 32
    第五章 結論與建議 56
    第一節 研究結論 56
    第二節 研究限制與建議 57
    參考文獻 58
    附錄 62
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  • 口試日期 2016-05-10 繳交日期 2016-08-07

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