國軍官兵門診醫療滿意度與忠誠度探討---某南部區域教學軍醫院為例

Satisfaction and Loyalty of Military Employee on the outpatient services : Example of a Southern Regional Teaching Army Hospital

李文俊(Wen-Chun Li)

指導教授 ： 邱亨嘉

高雄醫學大學/健康科學院/公共衛生學研究所碩士在職專班/碩士(2004年)

摘要

研究目的
本研究在探討某區域教學國軍醫院門診病人之特點，軍人與民眾在國軍醫院就醫的滿意度情形，在不同就醫科別，軍人與民眾在國軍醫院的滿意度情形，探討滿意度之重要影響因子，探討忠誠度與醫療服務滿意度及人口學之相關性。
研究方法
本研究是採用問卷調查方式，以醫療服務品質五個構面(環境設施等候時間、服務態度、醫療過程及服務結果)評量滿意度,以人口學分析滿意度的差異及探討滿意度之重要影響因子。以忠誠度的再選擇行為(願意再回診)及衍生行為(願意介紹親友就醫),分析人口學的差異,預測正向忠誠度的機率及滿意度與忠誠度相關性.
研究結果
軍人絕大部分為男性，平均教育程度較民眾高，1/2以上為當日現場掛號，七成以上駐地距離醫院遙遠。整體滿意度民眾平均3.75分，軍人平均3.65分，都接近滿意程度，表示軍人認同個案軍醫院的醫療服務品質。軍人對等候看病的時間及醫療後的結果滿意度最低，對工作人員服務態度及醫療過程的滿意度較高。民眾對內科系的滿意度最高,但在內科系就醫的官兵滿意度較民眾低，而其他科別就醫病患軍民滿意度沒有差異。由於科系的診室環境空間品質、診次人數的多寡、就醫民眾的疾病嚴重度、軍人的醫療以外求醫目的及醫師的服務態度，導致軍民滿意度差異。 女性、軍人、低教育程度、複診的病患，高滿意度的機率比較低.
滿意度與忠誠度(再選擇行為及衍生行為)正相關，在醫療結果及工作人員服務態度構面，滿意度越高，忠誠度的正向選擇的機率越高，服務結果的影響力最高。軍人、女性、高教育程度、初診的病患，正向忠誠度的機率比較低。除了滿意度會影響忠誠度以外，經濟因素及習慣因素亦會影響軍人對軍醫院的忠誠度。
討論與建議
醫院的經營及行銷方面，是以忠誠度的態度面(再回診及介紹親友就醫)為目標，個案軍醫院若能針對服務品質的軍民落差加以改善，提昇官兵的滿意度，預期官兵對個案軍醫院忠誠度(態度面)會超過民眾的忠誠度(態度面)。
建議醫院應設立預約掛號服務單位，主動與部隊醫療單位聯繫，利用語音掛系統或傳真官兵的就醫科別及診室，由醫院工作人員代為辦理預約掛號。醫院應增加內科系門診診次，開設官兵專屬門診，並增設檢查、檢驗及領藥獨立窗口，改善軍人對等候時間品質的不滿意。院方加強醫師顧客滿意服務觀念及對官兵病患的溝通藝術，以改善軍人對服務結果的不滿意。

關鍵字

醫療滿意度 ； 忠誠度 ； 軍人

並列摘要

Purpose :
The purpose of this research is to discuss the characteristics of the outpatient of certain regional teaching army’s hospital, the degree of satisfaction of the soldiers and ordinary people to the medical services of an army’s hospital, the satisfaction condition of them to different departments of the hospital, the essential influence factors of the satisfaction degree, and the correlation among loyalty, satisfaction degree of medical service, and demography.

Method :
I adopt the method of Questionnaire investigation. With the satisfaction degree according to five literary composition surfaces of medical care quality (Environmental facilities, Waiting time, Service attitude, Medical process, and Service results), the difference of the satisfaction degree analyzed by demography and discussion of the essential influence factors to satisfaction degree, the loyalty of the behavior of choosing again (the willing to the medical service once)and derivative behavior(willing to introduce the hospital to their relatives), I analyze the difference of the demography, and predict the probability of positive loyalty and correlation between satisfaction and loyalty.

Result :
The result of the research shows that most of the soldiers are male. Average level of education of them is higher than that of the ordinary people. More than 1/2 of them are not reserving the registering in advance. Among them, more then 70% come from stations far form the hospital. Total average satisfaction degree of the ordinary people is 3.75. That of the soldiers is 3.65. Both of them are close to satisfaction. It shows that soldiers approve the quality of the medical services of the sample army’s hospital. The lowest degree of satisfaction is about time to wait for service and results after treatment. The highest are workers’ attitude and medical process. Ordinary people are most satisfied with the department of internal medicine, but the satisfaction of the soldiers to the department of internal medicine is lower than ordinary people. There is no difference in the satisfaction to other department between soldiers and ordinary people. On account of the quality of the environment space of the consulting rooms, the number of people who come for treatment, the seriousness of the illness of the people seeking for medical service, soldiers’ purposes other than medical service, and doctors’ service attitude, the satisfaction degrees of the soldiers and the ordinary people are different. The probability of high satisfaction degree for female, soldiers, low educated patients, and patients that come for subsequent consultations to the hospital is less.
Satisfaction degree and loyalty (the behavior of choosing again and derivative behaviors) are positive correlated. When it comes to the configuration of treatment results and workers’ service attitude, the higher the satisfaction degree is, the higher the probability of loyalty’s positive choice. And the influence of the treatment result is greatest. The probability of positive choosing loyalty for soldiers, female, high educated patients, and patients who come for first consultation is less. Besides satisfaction degree, economic and habitual factors also influence the loyalty of the soldiers to the army’s hospital.

Discussion and Suggestion:
In aspects of hospital management and marketing, it takes the standard of the loyalty attitude as the objective. If the sample army’s hospital can ameliorate the difference service attitude to soldiers and ordinary people, promote soldiers’ satisfaction degree, it is expected that soldiers’ loyalty to the sample army’s hospital will exceed that of ordinary people.

Suggest the hospital should establish reserving registering service department. And it should communicate with the medical units in the troops actively. With the voice registering system or faxing soldiers’ data about what medical departments and rooms they need, workers in the hospital can charge the reserving registering for the soldiers. Furthermore the hospital should increase the number of internal medicine outpatient services, offer soldier only outpatient services, and establish independent windows for serving the soldiers. This will decrease the soldier’s dissatisfaction about the quality of waiting time. The hospital has to improve the doctor’s views about customers’ satisfying services and arts of communication with soldier patient to ameliorate the discontent of the soldiers about the treatment results.

並列關鍵字

Military employee ； Loyalty ； Satisfaction

參考文獻

中文文獻

1.黃素丹 門診病患滿意度調查與服務品質相關因素探討 醫院經營 30:2 民86.04.10-22

2.陳進福 就診因素與回診關聯性之研究-一眼科診所學童視力保建業務為例 民90論文

3.李安仁 官兵對某軍醫院醫療服務之寮解使用程度與滿意度調查研究 民83.1.公共衛生 20:4 353-362

4.高森永 全民健保第四類被保險人醫療服務利用情形及其影響因素 民86.11.國防醫學 25:5 399-406