探討醫院整體及藥事服務對於病患就醫意願之影響-以台灣南部某區域醫院為例

The influence of hospital and pharmaceutical services on public willingness to seek for medical care - A case study of a regional hospital in the southern area of Taiwan

洪佳蓮(Chia-Lien Hung)

指導教授 ： 林双金

高雄醫學大學/藥學院/藥學研究所碩士在職專班/碩士(2011年)

摘要

研究背景：隨著社會與經濟的快速發展，民眾的知識與思想水準大幅提升，對於醫療服務品質的要求也相對提升，醫院應該要了解民眾對各種服務重視的程度，以提供符合民眾需求的服務，來做為改進之優先順序，以利於醫院長期的發展。因此，本研究欲探討醫院為了符合評鑑所做的事項，其中醫院整體及藥事服務項目對於民眾就醫意願之影響。
方法：本研究對象是以2010年10月至12月，到個案醫院門診就醫的病患及家屬，以問卷調查的方式做為就醫意願測量之工具。本研究問卷以SPSS 15.0版統計軟體運用描述性統計分析、χ2 -test、單因子變異數分析（One-way ANOVA）等方法進行統計分析。
結果：「醫院不定期舉辦健康講座」及「提供病人用藥諮詢管道，如傳真、電話、e-mail..等」是先前文獻中尚未提到的部分，在本研究則顯示會增加病患就醫意願的比例較多，各佔54%和59.6%。性別對於「醫院不定期舉辦健康講座」( P值=0.011 )和「提供藥物使用說明服務（藥物諮詢）」( P值=0.016 )影響其就醫意願是有統計上顯著性差異的。知道醫院升級後掛號費增加，仍願意再度就醫者有68.5%，就醫的選擇主要是以考量離院距離及習慣性，此族群是屬於社區型病患，而醫療費用則是次要影響因素。若醫院再次升級為醫學中心，選擇到其他醫院與不一定者多於將再來本院者（P=0.000）。「媒體廣告的推薦」、「媒體正向新聞事件報導」及「媒體負向新聞事件報導」是以不會影響病患就醫意願的比例較多，各佔70.1%、58.9%及49%。
結論：「醫院不定期舉辦健康講座」及「提供病人用藥諮詢管道，如傳真、電話、e-mail..等」會增加病患就醫意願的比例居多，建議可加強宣導藥事服務項目，並定期舉辦健康及用藥相關演講活動。

關鍵字

就醫意願 ； 醫院服務 ； 藥事服務

並列摘要

Background: With the advances in societies and economics, the public’s healthcare knowledge increases dramatically that enhances the overall demands on healthcare quality. Therefore, it is imperative that hospitals understand how people value healthcare services for providing services that not only satisfy public needs, but also promote long-term organizational development. Hence, the purpose of this research was toinvestigate how hospital and pharmaceutical services affect public willingness for receiving medical care.
Method: The participants were patients (and their families) who went to a regional hospital in the southern area of Taiwan during October, 2010 and December, 2010. Questionnaires were used to measure public willingness to seek for medical care. Results were summarized and analyzed by χ2 test and one-way Analysis of variance (ANOVA) with SPSS 15.0.
Results: Results showed that “Holding healthcare seminars periodically” and “Providing patients with pharmaceutical consultations through fax, telephone, or e-mail” improve public willingness to seek for medical care,each accounting for 54% and 59.6% of the questionnaire responses. Gender has effects on public willingness for receiving medical care with respect to hospitals holding healthcare seminars periodically (p=0.011) and providing patients with pharmaceutical consultations (p=0.016). 68.5% of the participants would go to the same hospital even though the registration fee increases after the hospital moves up to a higher rank.
These participants typically live in the neighborhood. Their intention for receiving medical treatments was mainly affected by the distance between their home and the hospital, and the acclimatization to the hospital. Healthcare expenses were considered as a secondary factor that influenced public willingness to seek for medical care. When participants were asked that if a hospital becomes a medical center, the numbers of those who decided to go to other hospitals and those who responded "not sure" are higher than the number of those who decided go to the same hospitals (p=0.000). “Recommendations from mass media”, “mass media reports unbiased news” and “mass media reports news with bias” did not tend to influence public willingness to seek for medical care, each representing 70.1%, 58.9%, and 49% of the participants, respectively.
Conclusions:“Holding healthcare seminars periodically” and “Providing patients with pharmaceutical consultations through fax, telephone, or e-mail” improve public willingness to seek for medical care. This research suggests healthcare institutions should improve public awareness on pharmaceutical services and hold healthcare and pharmaceutical seminars regularly.

並列關鍵字

Willingness to seek for medical care ； hospital service ； pharmaceutical service

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