以Kano模式探討醫院服務品質與病患滿意度之研究

A study on Using Kano''''''''s model to explore the quality of hospital service and hospitalized patients'''''''' satisfaction

郭宜中(Yi-Chung Kuo)

指導教授 ： 湯玲郎

元智大學/管理學院/管理研究所/碩士(2001年)

摘要

由於教育的普及、科技與經濟的快速發展，使得國民醫療知識及生活水準普遍提高，進而對醫院服務品質的要求亦逐漸昇高。因此醫院除了致力提昇醫療服務品質及醫療形象，加強各項醫療服務的水準，以及開發新的服務項目與內容之外，如何歸納出一般民眾以及病患所重視的服務品質內涵，並建構一套完整的服務品質衡量模式，已成為各醫療機構目前極重視的議題。
本研究參考相關文獻及研究者多年的醫院臨床工作經驗，設計出「醫院服務品質重視度與滿意度調查表」，內容包括：環境與設備、舒適與清潔、工作人員服務態度、護理照護、醫師照護、飲食、住院/收費、信仰及醫療服務結果等九個服務品質構面及45項服務品質要素；此外，參考Kano二維品質模式，設計醫院服務品質Kano二維品質模式問卷表；相關問卷經三位專家效度與Cronbach α信度檢定後，於民國八十九年十一月至十二月，以一般民眾、醫院員工及住院病患三族群為研究對象，比較各族群對醫院服務品質重視度及Kano品質歸納之差異；另外並探討住院病患對醫院服務品質重視度與滿意度之相關性，以作為醫院管理者改善服務品質之參考。
本研究發現：
1.不同族群對品質要素充足及不充足的問項看法上，一般民眾與醫院員工及住院病患在大部分的問題上，其看法上有顯著差異。
2.不同族群對醫院服務品質各構面之重視程度，在「環境設備」、「工作人員服務態度」、「護理照護」、「醫師照護」、「住院/收費」、「信仰」等構面，均有顯著差異。
3.不同人口統計變項之病患，對醫院服務品質某些構面之重視度與滿意度有顯著差異。
4.Kano二維品質與醫院服務品質之重視度、滿意度間有相關性。

關鍵字

服務品質 ； 病患滿意度 ； Kano''''s 模式

並列摘要

Due to the pervasiveness of education and fast-developing technology and econo-
my, medical knowledge and living standards have widely increased, which in turn elevates people''''''''s standards for hospital services. Therefore, in addition to enhancing hospital services, promoting hospital images, and developing new items of service, medical organizations have currently emphasized the following two issues: (1) inductively finding out the service content that common people and patients consider important, and (2) constructing a well-developed evaluation model to appropriately ass-
ess the quality of service. Thus, this study intends to address some aspects of these tasks.
The purposes of this study were to (1) explore and compare the extents of three groups'''''''' value on the quality of hospital services with Kano''''''''s two-dimensional model and to (2) investigate the correlation between the extent of hospitalized patients'''''''' value on the quality of hospital services and their satisfaction with the quality of those hospital services. The participants of this study represented three cross-sections of the general population: common people, hospital employees, and hospitalized patients. The instrument of this study contains two questionnaires. The first questionnaire was developed based on the researcher''''''''s literature review and her over twenty years of clinical working experience. It consists of nine dimensions with 45 items which aim to assess the quality of hospital services in terms of (a) environment and facilities, (b) comfort and cleanliness, (c) employees'''''''' service attitude, (d) nursing care, (e) physician care, (f) diet, (g) admission and bill, (h) religion, and (i) outcome of medical services.
The second questionnaire was designed mainly on Kano''''''''s two-dimensional model to evaluate the quality of hospital services. After consulting three experts to ensure good content validity and conducting the pilot testing with every cronbach α ≧ 0.87 , the researcher administered these two questionnaires to the participants from the aforementioned three groups from November 2000 to December 2000. The results of this study showed that 1) there was a statistically significant difference among the three grouped participants in most items assessing the sufficiency and insufficiency of quality elements. 2) there were statistically significant differences among the three groups in the extent of values concerning (a) environments and facilities, (c) employees'''''''' service attitude, (d) nursing care, (e) physician care, (g) admission and bill, and (h) religion respectively. 3) some of the demographic variables respectively had significant effects on some dimensions, thereby assessing the extent of value on and satisfaction with the quality of hospital services. 4) Kano''''''''s two-dimensional quality correlated respectively with the extent of value on the quality of hospital services and with the extent of satisfaction derived from hospital services.

並列關鍵字

service quality ； patients'''''''' satisfication ； Kano''''''''s model