在健保開辦和健保制度持續調整、醫療產業的高度競爭和病患意識抬頭等社經環境的變遷下，服務管理思維開始成為醫院管理重要的一環。
對醫院而言，可藉由改善醫療服務品質，來降低醫療糾紛、醫療傷害等等對醫院和病患皆不利的醫療過失行為，藉此減低醫事行政成本的支出。醫療服務品質更是影響病患滿意度之重要影響因素，提高醫療服務品質不僅能提高病患滿意度，更進一步能提高病患忠誠度，長期持續的良好醫病關係將有助於醫院永續經營的形象與口碑的建立。
對病患而言，醫院服務品質的改善，使其接受到更加良好的醫療照護時，病患身心的健康情況也隨之有良好的改善，提高其對醫院之醫療服務滿意度，進而對醫院產生信任與依賴。
本研究利用PZB模式（Parasuraman, Zeithaml and Berry Model，1985）和醫療服務品質構面，探討醫院之服務缺口，了解醫院病患和醫院本身對醫療服務品質之間的差異，是否影響病患對醫療服務品質的滿意度，更進一步了解服務品質與病患滿意度對病患就醫行為與忠誠度建立之影響。實證結果亦顯示服務品質與滿意度對忠誠度呈現正向之關係。
最後針對PZB的醫療服務品質構面中的「有形性」、「可靠性」、「反應性」、「保證性」提出具體改善方向，期望醫療服務之提供者能利用研究的結果，找出問題的癥結所在，進而改善醫療服務品質，提高病患滿意度，以增進病患對醫院之忠誠度。

Health care quality become an important issue of hospital’s management while the change of external environment such as the National Health Insurance program implementation and continuously reformed. The medical market turned into the highly-competitive, and patients are more concern their right and the quality of health care.
By health quality improvement, hospitals can reduce medical malpractice and decrease the costs of medical administration. Health service quality is also an important factor of patient satisfaction. Increasing health service quality not only can improve patient satisfaction but also increase patient loyalty. And patient can get better medical care through the improvement of health service quality. It will increase their satisfaction and loyalty of hospital. The long-term relationship between hospitals and patients will help hospitals built their better image and reputation.
This study applies PZB model and health quality factors to survey gaps of health service, the difference of service quality, patient satisfaction and patient loyalty. The result shows that service quality and satisfaction have positive effect of loyalty.
At last, according to critical study findings, this thesis proposes certain suggestion. Wish medical managers can use these results to explore the key problem of health service. Through improvement of health service quality, it may raise patient satisfaction and increase patient loyalty to the hospitals.

謝詞 ----------------------------------------------------------------------II
中文摘要 -----------------------------------------------------------------III
英文摘要 -----------------------------------------------------------------IV
目錄 ----------------------------------------------------------------------V
表目錄 ------------------------------------------------------------------VIII
圖目錄 -------------------------------------------------------------------IX
第一章 緒論 ---------------------------------------------------------------1
第一節 研究背景與動機 ---------------------------------------------------1
第二節 研究目的 ---------------------------------------------------------2
第二章 文獻探討 -----------------------------------------------------------4
第一節 服務品質 ---------------------------------------------------------4
第二節 醫療服務品質與評估 ----------------------------------------------11
第三節 服務品質缺口 ----------------------------------------------------14
第四節 病患滿意度 ------------------------------------------------------17
第五節 病患忠誠度 ------------------------------------------------------18
第六節 服務品質、顧客滿意度與顧客忠誠度之關係 --------------------------20
第三章 研究方法 ----------------------------------------------------------22
第一節 研究架構 --------------------------------------------------------22
第二節 研究假設 --------------------------------------------------------24
第三節 問卷設計 --------------------------------------------------------24
第四章 資料分析與研究結果 ------------------------------------------------27
第一節 受訪者之基本資料分析 --------------------------------------------27
第二節 醫療服務品質缺口之假設檢定 --------------------------------------35
第三節 人口統計變項與缺口間關係之檢定 ----------------------------------39
第四節 其他假設檢定 ----------------------------------------------------62
第五節 服務品質、病患滿意度對病患忠程度之路徑分析 ----------------------68
第五章 結論與建議 --------------------------------------------------------71
第一節 研究結果 --------------------------------------------------------71
第二節 研究建議 --------------------------------------------------------76
參考文獻 -----------------------------------------------------------------79
一、中文部份 -----------------------------------------------------------79
二、英文部分 -----------------------------------------------------------79
附錄一、病患問卷 ---------------------------------------------------------84
附錄二、醫護與一般行政人員問卷 -------------------------------------------88

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