以不同門診模式探討牙醫病患滿意度與醫療品質重視度之關係

研究背景與目的現行的醫事機構分級制度下，牙科門診可依所屬機構分級為醫學中心門診、區域醫院門診和市區基層門診。本研究嘗試由門診均是醫學中心醫事人員為主體，成立不同模式的牙科門診。針對至醫學中心求診的牙科患者，了解選擇就醫的重要因素。對醫學中心牙科團隊各項服務滿意度和重視程度；並尋求出以醫學中心醫事人員為主體的最佳牙科門診模式。期望能提供給醫學中心牙科提升醫療服務品質的參考。材料和方法以高雄某醫學中心體系之牙科門診、醫學中心牙科院外門診、前金區市立醫院牙科門診和小港區市立醫院牙科門診就醫的民眾，採取門診收案的方式，進行問卷調查。共回收有效問卷1,163份，醫學中心牙科門診有546份，醫學中心牙科院外門診有283份、前金區市立醫院牙科門診有173份和小港區市立醫院牙科門診有161份。所得問卷資料以Microsoft Excel進行編碼建立資料庫，再使用IBM SPSS Statistics 19統計軟體進行資料的統計分析，進行t-test、單因子變異數分析、相關係數和迴歸分析等的統計分析。研究結果研究結果中顯示「醫療設備齊全」、「服務態度佳」、「醫師醫術高超名聲好」則是本研究中病患選擇就醫的主要考慮因素。病患對於醫師的專業能力和技術熟練度、希望由同一個醫師進行完整的治療、醫師仔細診察及詳細說明治療計畫最為重視；而看診後電話關懷之服務、候診區設備、門診診間的裝潢與隔間最不重視。而對於醫師的學經歷與專科醫師資格、醫師的專業能力和技術熟練度、希望由同一個醫師進行完整的治療的滿意度最高；至於如果接受實習醫師的治療、停車便利性、候診區設備滿意度的結果則是最低。結論與建議研究調查也發現，民眾較傾向於同一醫師診療的看診方式。醫師的專業能力和技術熟練度、希望由同一個醫師進行完整的治療是民眾的重視程度高而且滿意度也高的項目，代表醫學中心在民眾心目中是有一定的水準，因此未來醫學中心牙科發展的重心除維持應有的醫療服務水準之外，也要改善候診區設備環境及停車的便利性。重視程度和滿意度的調查方面，醫學中心牙科院外門診普遍高於其他三個地區。在以醫學中心醫事人員為主體的條件下，採取不同專科醫師在同ㄧ診療空間為病患進行牙科治療是較能被接受的門診模式。在現今的醫病關係下，病患要求的不只是醫療結果的滿意，對於輔助人員和設施，乃至於配合的軟硬體的重視程度，都較往日不同。提升醫學中心牙科的醫療品質和病患滿意度已是刻不容緩的課題了。

關鍵字

滿意度

並列摘要

Background：Under the classification system for current Taiwan medical institutions, the dental clinics can be to classified as medical center clinic, regional hospital clinic and private dental clinic. Furthermore, according to the characteristics of human resource composition, the dental clinics are classified into greater dental clinics, chain dental clinics and union dental clinics. This study was attempted to investigate the relationship between satisfaction and quality of the dental services based on the medical center faculties in different dental clinic models. To comprehend the important factors in selection of dental treatment for patients seek for medical services in medical center, through the analysis of the satisfaction and importance in each dental treatment services provided by the medical center dentistry faculties, this study could propose the best model for dental clinics. This study also expects to improve the quality of dental treatment services in a medical center. Materials and methods：These samples of the presont study were collected at the dental departments at: a medical center and its downtown dental clinic in Kaohsiung city and two Kaohsiung Municipal Hospital(Cianjin district and Hsiaokang district) with structured questionnaires. A total of 1,163 questionnaires were valid, 546 questionnaires from the dental department of a medical center, 283 questionnaires from its downtown dental clinic, 173 questionnaires from Cianjin municipal hospital and 161 questionnaires from Hsiaokang municipal hospital. All data were encoding with Microsoft Excel to establish the database and then used IBM SPSS Statistics 19 statistical software for statistical analysis. Results：The results of this study revealed the major factors which affected patients, about their choice of dental clinics were well-equipped medical instruments, excellent medical services and doctor’s professionalism. The patients emphasize the dental treatment abilities and techniques, treatment by the same dentist, fine attitudes of dentists and complete ness of treatment plan explanation. On the contrary, recall services for care, facilities in the waiting area and decoration and partition of clinic were the least important factors. The highest satisfaction for patients was related to academic background, specialist of dentists, abilities, techniques of dentists and treated by the same dentist. On other hand, patients were the least in treatments by interns, satisfied convenience for car parking and facilities in waiting area. Conclusion：This study concluded that patients tended to like their treatments by the a same dentist. Patient consider the abilities and techniques of dentists and treatment by the same dentist the most important factors affecting the satisfaction of dental service. These results also revealed that order to provide high satisfaction dental service, the dental department of a medical center should not only maintain the standard level in dental treatment services but also renew its facilities in waiting area and convenience for car parking. The suitable dental clinic model was that patients, treatments by different specialists in the same clinic and based on the medical center faculties. In view of current relationship between patients and doctors, the improvement of medical service qualities and rise up the patient’s satisfaction are the most important issue.