過去醫療資訊不透明的年代，民眾對於選擇自己喜愛的醫療院所，往往缺乏有效的資訊，由於全民健康保險的實施以及二代健保的改革，規定醫療院所的醫療品質資訊必須公開、透明化。然而，在競爭激烈的醫療產業中，為了達到永續經營的目標，各醫院莫不以提昇醫療服務品質與病人滿意度，但醫療服務品質是一個抽象的概念，民眾依據自己的主觀意識對服務品質進行解讀，因此每個人對於服務品質的好壞有不同的認知。
本研究採用Parasuraman, Zeithaml, & Berry (1988)所提出的服務品質五大構面：有形性、可靠性、反應性、保證性、同理心以及SERVQUAL量表作為本研究問卷並進行修正。利用Kano二維品質模型，設計出醫療服務品質之Kano二維品質問卷，將民眾對於醫療服務品質之感受進行品質要素歸類；再利用重要-表現程度分析法探討民眾對醫療服務品質的重視程度與滿意程度之關係。
本研究以民眾為研究樣本，有效樣本213份，有效回收率96.38%，其中男性有119位(55.9%)，女性有94位(44.1%)。本研究使用統計軟體SPSS 20.0版進行統計分析，以描述性統計、T檢定、卡方檢定、單因子變異係數分析與事後多重比較、皮爾森相關係數等統計方法分析後，本研究結果發現：
一. 醫療服務品質構面在Kano二維品質模型上會有不同的品質要素歸類。
二. 不同人口統計變項的民眾，對於Kano二維品質模型的服務品質要素歸類上有顯著差異。
三. 不同人口統計變項的民眾對醫療服務品質構面重視度有顯著差異。
四. 不同人口統計變項的民眾對醫療服務品質構面滿意度有顯著差異。
五. 民眾對各醫療服務品質構面的重視程度與滿意程度呈正相關。

根據以上的研究結果，本研究認為醫療院所的管理者在進行提升或改善醫療服務品質時，可先將Kano二維品質歸類中屬於必須品質的項目作為第一優先，其次是一維品質，最後再朝向魅力品質邁進。
醫療院所的管理者可以透過重要-表現程度的分析結果，進行醫療服務品質改善時的先後順序之策略擬定，除了能提升民眾對於醫療服務品質的滿意度之外，也能成為與其它醫療院所競爭的優勢。

In the past, the medical information was not transparent, people usually lacked the effective information sources when choosing the medical service institutes they liked. However, due to the implement of Taiwan National Health Insurance and the innovation of Second Generation National Health Insurance, Ministry of Health and Welfare (MOHW) regulated that all the information about medical quality of each medical service institutes had to be known to the public and transparent.
Moreover, to survive from the keen competitive health care market and to achieve the goal of sustainable management. The medical service institutes promotes their health care quality to raise the satisfaction from patients. But medical service quality is an abstract conception, people tend to judge the service quality based on their subjective consciousness, therefore, there are different perspectives on service quality.
This study’s questionnaire adopted the five aspects of service quality: Tangibles, Reliability, Responsiveness, Assurance, Empathy, and revised SERVQUAL Scale addressed by Parasuraman, Zeithaml, & Berry in 1988. The questionnaire was designed on Kano’s two-dimensional model to evaluate the medical service quality, it categorizied the quality attributes according to public’s feeling of medical service quality. And then to explore the relation between degree of perceived importance and performance of medical service quality by Importance-performance analysis.
The samples of this study were from people who live in Kaohsiung-Pingtung area, while effective response rate was 96.38%,the effective sample size was 213. (male = 119<55.9%>, female = 94<44.1%>). The samples were analyzed with SPSS 20.0 . The statistic methods used in this study were reliability analysis, descriptive statistics, T-test, Chi-square Test, One-way ANOVA, Pearson correlation.
Our empirical results showed：
1. The aspects of medical service quality have different categorizations on quality attributes in Kano’s two-dimensional model.
2. There is a statistically significant difference on categorizations of service quality for people of different demographic valuables towards the attributes in Kano’s two-dimensional model.
3. There is a statistically significant difference on degree of perceived importance of medical service quality from people of different demographic valuables.
4. There is a statistically significant difference on satisfaction of medical service quality of medical service quality from people of different demographic valuables.
5. It showed positive correlation between importance and satisfaction on medical service quality.

According to the results of this research, the study indicated that the hospital executives could regard the must-be quality in Kano' two-dimensional model as the first priority when undertaking the promotion of medical service quality, later the one-dimensional quality and then the attractive quality followed.
The hospital executives could draft priority of strategy on improvement of medical service quality according to the results of Importance-performance analysis. It is not only to raise the satisfaction from public but also becomes one of the competitive advantages in health care market.

論文審定書................................................................................................................................ i
誌謝........................................................................................................................................... ii
中文摘要.................................................................................................................................. iii
Abstract ..................................................................................................................................... v
目錄......................................................................................................................................... vii
圖 次....................................................................................................................................... x
表 次...................................................................................................................................... xi
第一章緒論............................................................................................................................. 1
第一節研究背景及動機................................................................................................. 1
第二節研究目的............................................................................................................. 4
第二章文獻查證..................................................................................................................... 5
第一節醫療服務品質..................................................................................................... 5
一、醫療服務品質的定義......................................................................................... 5
二、醫療服務品質構面........................................................................................... 10
三、醫療服務品質之相關研究............................................................................... 13
第二節Kano二維品質模型.......................................................................................... 15
一、Kano模型介紹.................................................................................................. 15
二、Kano二維品質模型的建立.............................................................................. 18
三、Kano二維品質模型之相關研究...................................................................... 20
第三節重要-表現程度分析法(Importance-performance analysis).............................. 22
第三章研究方法................................................................................................................... 26
第一節研究架構與假設................................................................................................... 26
一、研究架構........................................................................................................... 26
二、研究假設........................................................................................................... 28
三、研究對象、抽樣方法與資料收集程序........................................................... 29
第二節研究工具問卷設計............................................................................................... 31
一、問卷編製過程................................................................................................... 31
二、研究變項的操作型定義................................................................................... 34
第三節信效度分析........................................................................................................... 40
一、效度分析........................................................................................................... 40
二、信度分析........................................................................................................... 40
第四節資料處理與分析方法........................................................................................... 41
一、描述性統計分析............................................................................................... 41
二、Kano二維品質模型歸類法.............................................................................. 41
三、推論性統計分析............................................................................................... 42
第四章研究分析與結果....................................................................................................... 43
第一節描述性統計分析............................................................................................... 43
一、基本資料分析................................................................................................... 43
第二節推論性統計....................................................................................................... 47
一、Kano二維品質模型歸類.................................................................................. 47
二、不同人口統計變項對Kano二維品質模型歸類............................................. 51
三、Kano顧客滿意係數.......................................................................................... 55
四、重要-表現程度分析法...................................................................................... 57
五、不同的人口統計變項對醫療服務品質重視度與滿意度之差異分析............ 61
六、民眾對各醫療服務品質構面的重視程度與滿意程度有相關性.................... 75
第五章討論與建議............................................................................................................... 77
第一節研究討論........................................................................................................... 77
一、民眾對於醫療服務品質之Kano二維品質模型分析討論............................. 77
二、民眾對於醫療服務品質之重視度與滿意度討論........................................... 80
三、人口統計變項對醫療服務品質構面重視度與滿意度之差異分析、相關性討論………………………………………………………………………………….83
第二節研究限制........................................................................................................... 85
第三節建議................................................................................................................... 86
一、對後續研究者的建議....................................................................................... 86
二、對醫療院所管理者的建議............................................................................... 87
三、研究貢獻........................................................................................................... 88
參考文獻................................................................................................................................. 89
附 錄..................................................................................................................................... 94
附錄一：本研究問卷......................................................................................................... 94

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