病患忠誠度之研究：探討對機構、醫師及護理師滿意感之影響

The Determinants of Patient Loyalty: Exploring the Impact of Institutions, Physician, and Nurse Satisfaction

黃佑安(Yn-An Huang) ； 鍾任琴(Chin Chung-Jen) ； 徐永堂(Gaudi Yung-Tang Hsu) ； 賴鴻池(Hung-Chih Lai)

《健康管理學刊》 17卷1期 (2019/06) Pp. 13-40

摘要

病患忠誠度是關乎醫院診所長期存活的關鍵，過去的關係行銷研究忽略了顧客與第一線員工間的親近關係對廠商關係可能產生的危害，例如：醫師可能帶走整批的病患；也缺少將員工進一步分成主力與輔助角色，從關係前因、關係中介與調節變項的角度進行研究。本研究將洗腎院所、醫師與護理師分為關係前因、關係滿意中介與結果三組變項，並將關係滿意探究其調節角色，分析其間影響關係。回收210份有效問卷，採用結構方程式（PLS-SEM）進行分析，研究結果為：（1）聲望是洗腎院所的重要前因，有助於增強洗腎者對院所的滿意，進而增強洗腎者對洗腎院所的忠誠；（2）專業性與親和力是醫師的主要關係前因，能夠提高洗腎者對醫師的滿意，部份地增強洗腎者對院所的忠誠；（3）傾聽與照護能力是護理師的關鍵前因，增強洗腎者對護理師的滿意，但無法提升洗腎者對院所的忠誠；（4）關係滿意的中介效果上，護理師滿意無法中介影響院所忠誠，但能夠透過對院所與醫師滿意的中介效果與前因變項產生影響。研究意涵建議醫療服務廠商善用顧客、廠商與員工關係前因—中介—結果的架構，可有助提升顧客、員工與廠商三者的關係結果。

關鍵字

病患忠誠度 ； 血液透析服務 ； 病患與醫院關係 ； 病患與醫師關係 ； 病患與護理師關係

並列摘要

Patient loyalty has been gaining more attention as hospitals face increasing competition. Previous research did not consider patient loyalty to consist of loyalty to the hospital and to the specific physician and nurse. For instance, the physician can potentially bring most patients under their care when they leave. Past research also did not subcategorize employees into main and supporting roles. Therefore, by applying the relational antecedent-mediator-outcome framework, this study investigates how patients' relational antecedents and mediators tie with how hospital, physician, and nurse affect patient loyalty in dialysis service. In such a framework, the authors consider the patient-hospital, patient-physician, and patient-nurse relationship in parallel. Through a survey research conducted in four dialysis centers of Taiwan with 210 valid responses, the results applied with PLS-SEM analysis confirm (1) the significance of reputation as the antecedent of patient-hospital satisfaction that influence patient-hospital loyalty, (2) the notable role of expertise and likability of physician as two components of patient-physician satisfaction that partially affect patient-hospital loyalty, (3) the importance of listening and caring ability of nurse as the antecedent of patient-nurse satisfaction but does not influence patient-hospital loyalty, (4) the indispensable moderating and antecedent roles of patient-nurse satisfaction in strengthening patient-hospital and patient-physician satisfaction that in return increase patient-hospital loyalty. The findings provide several implications for researchers and managers in regard to how a relational antecedent-mediator- outcome framework can enrich customer service encounters and how to manage customer-staff relationships properly.

並列關鍵字

Patient loyalty ； Dialysis service ； Patient-hospital relationship ； Patient-physician relationship ； Patient-nurse relationship