公民營醫院內部服務品質、組織承諾與組織公民行為比較之探討─以高雄市立醫院為例

研究目的為維持在醫療市場的競爭力，醫院除了提升自身的醫療品質之外，人力資源管理亦是一大重點，人為組織最重要之資源，如何留用適當員工減少離職及招募成本，有效發揮每位員工潛能，提升員工服務熱忱以提高醫療服務品質，為醫院重要經營策略之一。醫院依照屬性可略分為公營及民營2種，本研究旨在探討公民營市立醫院在內部服務品質、組織承諾與組織公民行為三項變數有無差異及內容，期能截長補短，互相借鑑，讓公民營醫院共同成長。研究方法本研究採橫斷式問卷研究法，以高雄市二間市立醫院（公、民營各1間）之員工為研究對象，納入條件包含正式及非正式人員，但排除二院以外包、採購方式進用，非直接聘用之人員。包含醫師、護理人員、行政人員、醫技人員與其他技術人員（含工務、資訊等）由醫院聘用之員工均為研究對象，問卷內容經過信效度審查，並通過IRB審查後始予發後，總計發放800份問卷，回收有效問卷723份，有效回收率90.375%。研究結果一、公營醫院與民營醫院在醫院內部服務品質(P<.0005)、組織承諾(P=.001)與組織公民行為(P=.036)有顯著差異，民營醫院三者均顯著優於公營醫院。二、醫院員工之年齡、任職型態、職業類別、擔任職位、服務年資及教育程度，均在醫院內部服務品質、組織承諾與組織公民行為有顯著差異。三、醫院內部服務品質、組織承諾與組織公民行為三變項間有顯著正相關(P<.001)。四、醫院權屬別以及部分個人屬性變項，對醫院內部服務品質、組織承諾與組織公民行為有顯著性的影響，惟其解釋力皆偏低。結論與建議經本研究發現民營醫院之內部服務品質、組織承諾與組織公民行為均顯著優於公營醫院，顯示整體而言民營醫院能提供給員工較佳之工作環境，員工較能對醫院產生情感性依附並願意留任，且願意為醫院利益而付出額外行動。實務上，建議醫院管理部門可透過各種不同管道如問卷、訪談及座談會等，確實得知員工對醫院內部服務的感受，及希望改進的部分，並瞭解員工對組織的態度、行為及其影響原因，以作為醫院政策修訂及人力資源管理之參考；另建議公營醫院應向民營醫院學習組織管理之策略，以及院方所提供之內部服務，以改善員工對醫院之感受及其行為態度。本研究僅針對公民營各一間醫院進行研究，建議後續研究者可擴大研究範圍，並可結合經營績效表現，分析比較經營績效是否受到組織行為之影響。

關鍵字

公民營醫院；內部服務品質；組織承諾；組織公民行為；問卷調查

並列摘要

Objectives In order to maintain the competitiveness of the hospitals, it is important to enhance their human resources management. How to retain the appropriate staff to reduce turnover and recruitment costs, improve each employee’s potential, and enhance the enthusiasm of staff to improve the quality of medical services is one of the important business strategy for hospitals. The purpose of this study is to explore the differences of internal service quality (ISQ), organizational commitment (OC) and organizational citizenship behavior (OCB) between public and private hospitals, which can be used to learn from each other. Methods In this study, the cross-sectional structured questionnaire survey was used to study the staff of the two municipal hospitals (public and private) in Kaohsiung City. All occupation types were included, whether formal and informal employee. This study was reviewed and approved by the Institutional Review Board, and the reliability and validity were compiled with a standard. A total of 800 questionnaires were distributed, 723 valid questionnaires were retrieved and the effective recovery rate was 90.375%. Results 1.There were significant differences between public hospital and private hospital in ISQ (P <.0005), OC (P = .001) and OCB (P = .036). Private hospital was significantly better than public hospital in ISQ, OC, and OCB. 2.The age, type of employment, occupation type, position, service year and education of hospital staff were significantly different in ISQ, OC and OCB. 3.There was a significant positive correlation between hospital ISQ, OC and OCB (P <.001). 4.Hospital types and personal variables have a significant influence on the ISQ, OC and OCB. But the total variance can be explained was low. Conclusion and suggestions The results show that the ISQ, OC and OCB of private hospitals are significantly better than those of public hospitals. It shows that the private hospitals can provide better working environment for the employees. The employees are more willing to stay and to pay extra action for the benefit of the hospital. It is recommended that the hospital management department can use some methods such as questionnaires, interviews and meetings to know the feelings and attitude of employees. It is also suggested that public hospitals should learn from private hospitals to organize management strategies in order to improve the staff's feelings, attitude and behavior.