國軍某區域醫院軍民就醫選擇因素、滿意度及忠誠度之探討

Patient Health-Seeking Selection, Satisfaction and Loyalty between the Military and the Populace in a Regional Army Hospital

沈素華(Su-hua Shen)

指導教授 ： 葉德豐

中臺科技大學/管理學院/健康產業管理研究所/碩士(2011年)

摘要

國軍醫院肩負社區民眾及官兵醫療保健、重大災變之醫療支援以及戰時演訓多重功能；再加上面臨遭受軍方員額精簡、周邊醫院林立及病源流失等衝擊；且現行健保總額環境下，醫療院所競爭激烈，使得國軍醫院經營更加嚴峻，因此，探討國軍醫院病患之就醫選擇因素，藉以提昇滿意度及忠誠度，並提供經營管理建議，以強化醫院競爭能力，為國軍醫院重要課題。
本研究採橫斷性研究方式，針對中部某國軍醫院500位門診病患，採結構式問卷、配額抽樣方式蒐集資料，問卷內容包括病患特質、就醫選擇因素、滿意度及忠誠度等部分。
研究結果顯示，複診病患及60歲以上之族群均較其他年齡在滿意度及忠誠度為高；另外軍人族群在病患忠誠度低於其他非軍人族群；就醫選擇因素對滿意度及忠誠度之影響均以醫療服務構面(β係數分別為0.426及0.441)為最高；滿意度對忠誠度有正向影響 (R2=58.5%)。
建議醫院應著重醫師服務態度、醫學倫理教育，提高醫療水準，保持良好醫病關係，以增加病患滿意；另外在加強軍人對醫院忠誠部分，應改變以往被動經營思維，考量主動至駐地辦理健康講座、溫馨接送及軍方客製就醫流程等，以創造國軍醫院核心價值。

關鍵字

國軍醫院 ； 忠誠度 ； 滿意度 ； 就醫選擇因素

並列摘要

The mission of army hospital includes providing health care for community people and the armies, and supplying medical aid for serious disasters and wars. Besides, the downsizing of the army, growing nearby competitors, and the patient outflow resulted to the more threats that the army hospital must face it. There were several constrains such as the great budget system resulting to the great competition between hospitals. Thus, to discover the health-seeking selection among patients to enhance patient satisfaction and loyalty became an important issue for army hospitals.
This cross-sectional study selected 500 outpatient patients by quota sampling. Structured questionnaire contained four parts such as personal characterstics, health-seeking selection, satisfaction, and loyalty.
The results illustrated that subsequent–visit and above 60 years old patients have higher loyalty and satisfaction than first-visit and other ages. In addition, the military patients have lower loyalty than other non-military patients. Medical service, one of the health-seeking selection, was the highest domain both in loyalty and satisfaction (β coefficients are 0.426 and 0.441, respectively).There were positive association between satisfaction and loyalty (β coefficient is 0.385).
The army hospital should focus on the attitude and medical ethics of the doctors in order to promote patient satisfaction, loyalty, and physician-patient relationship. Furthermore, to enhance the loyalty of military patients, army hospital should provide more active health educational programs, transportation services and customized service processes.

並列關鍵字

satisfaction ； health-seeking selection ； army hospital ； loyalty

參考文獻

7.吳侖瑾、涂文菁、隋安莉 (2008)。台灣東部某區域醫院病患滿意度及忠誠度之探討。嘉南學報，(34)，713-726。

2王乃弘（1999）。民眾就醫選擇之研究-分析層級程序法之應用。中華衛誌，18(2)，138-151。

22.張櫻淳（1998）。醫院形象定位之研究-以台北市六家醫學中心的家醫科就診民眾為例。中華衛誌，17(2)，111-124。

19.許榮譽、溫源鳳、徐東寶（2008）。醫療品質、病患滿意度與病患後續醫療行為意圖-以國軍南部某醫院為例。危機管理學刊，5(2)， 49-60。

3.古慧仙、古慧嬋、張彩秀（2007）。影響門診病患就醫忠誠度之相關因素探討。澄清醫護管理雜誌，3(1)，36-45。