病患與醫護人員對醫療服務品質認知落差之探討－以心導管利用爲例

Quality Gap between Patients and Medical Professionals for Cardiac Catheterization Services

葉娟娟(Chuan-Chuan Yeh) ； 蔡文正(Wen-Chen Tsai) ； 鍾政達(Cheng-Ta Chung) ； 龔佩珍(Pei-Tseng Kung)

《醫務管理期刊》 9卷1期 (2008/03) Pp. 1-20

https://doi.org/10.6174/JHM2008.9(1).1

摘要

目的：本研究主要探討心導管病患對醫療服務品質之期望與醫護人員對病患醫療品質期望認知之落差（缺口一），及病患對醫療品質的期望與滿意度之落差（缺口五）及其相關因素。
方法：本研究利用PZB服務品質模式，以問卷調查方式，以四家醫院的心導管醫護人員及病患爲研究對象，醫護人員有效問卷75份，回收率76.5%；病患603份，回收率86.1%。應用複迴歸分析探討影響缺口五之因素，及探討影響病患就醫整體滿意度之相關因素，並利用重要性／績效分析法探討病患對心導管醫療服務品質的迫切改善項目。
結果：在缺口一，五個衡量構面之落差依序爲回應性、有形性、同理性、保證性及可靠性。缺口五之五個衡量構面落差依序爲有形性、回應性、同理性、可靠性與保證性。影響缺口五之相關因素爲家庭平均月收入、疼痛嚴重度、手術部位和就醫層級。影響病患對醫療整體滿意度的顯著因素，包括病患的教育程度、家庭月收入、疼痛嚴重度及同理性構面滿意度。重要性／績效分析法則發現落在迫切改善區之項目爲：「安全的設備」、「整潔舒適的環境」、「專業的穿著」、「足夠的專業知識回答病患問題」和「以病患的最大利益爲優先考量」。
結論:心導管醫護人員與病患對醫療服務品質之期望及感受認知存在落差，醫院可以應用此方法找出醫療服務品質缺口加以改善。

關鍵字

心導管檢查 ； 缺口 ； 服務品質 ； 滿意度 ； 重要性／績效分析

並列摘要

Objectives: This study investigated the perception gap of the medical quality between the medical professionals and patients for coronary catheterization (i.e. gap 1) and the gap between the expectation and satisfaction of the patients (i.e. gap 5), and the related factors.
Methods: The study used PZB model and collected data with questionnaire by interview. The study samples included the physicians and nurses of the catheterization room and the patients receiving coronary catheterization at four hospitals. A total of 75 physicians and nurses (returned rate 76.5%) and 603 ptients (returned rate 86.1%) participated in this study. This study performed multiple regression analysis to examine the gap 5 and to examine the related factors influencing the global medical satisfaction. Finally, we used the importance-performance analysis to examine the service items needed to be concentrated for improvement.
Results: For the gap 1, the dimension of responsiveness was ranked the first, then the tangibles, empathy, assurance and reliability as order. For the gap 5, the ranks of 5 dimensions were tangibles, responsiveness, empathy, reliability and assurance as order. Multiple regression analysis revealed that average family income, degree of physical discomfort, operation site and the hospital level had different effects on gap 5. The factors associated with the patient's global satisfaction included the level of patient's education, average family income, severity of the pain and satisfaction with the empathy dimension. IPA showed that safe equipment, clean and comfortable environment, professional knowledge and the first consideration of the patient's advantage fell in ”concentrate here” for improvement.
Conclusion: The quality gaps of expectation and perception between medical professionals and patients for coronary catheterization existed. Hospitals could apply this method to improve quality gaps.

並列關鍵字

Coronary catheterization ； gap ； service quality ； satisfaction ； importance-performance analysis

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