母嬰親善醫院醫療服務品質與產婦忠誠度探討

Discussion of Baby-Friendly Hospital Medical Service Quality and Loyalty of Postpartum Women

洪靜琦(HUNG CHING CHI)

指導教授 ： 藍守仁 ； 蔡宜勳

亞洲大學/健康學院/健康管理研究所/碩士(2008年)

摘要

全民健保實施以來，醫療產業競爭日趨激烈，醫院除了加強醫療設備與技術外，更重視醫療服務品質，以期能增加顧客的滿意度與忠誠度，進而提升醫院營運績效。母嬰親善醫院認證是衛生署近年來大力推行的政策，希望透過十大措施的實行，使母乳哺餵成為常規的醫療照護環境，並給予嬰兒生命最好的開始。本研究提出一個理論模型，說明在母嬰親善醫院裡，產婦哺乳意向、產後照護品質、醫護人員哺乳支持度之間的相關，以及對醫院服務品質及產婦忠誠度的影響，並分析人口學變項之不同群組，在整個理論模型上的差異，希望能瞭解母嬰親善醫院政策，是如何影響醫療服務品質及產婦忠誠度，其結果可進一步做為衛政單位及醫療院所政策推行之參考。
本研究係針對中部某所推行母嬰親善政策的指標醫院，以剛生產後住院中的婦女為施測對象，共回收210份問卷，透過敘述性統計分析、卡方檢定、結構方程模式、多群組分析等統計方法，驗證本研究模型。結果發現（1）醫院服務品質與產婦哺乳意向，對產婦忠誠度有顯著的影響。（2）產後照護品質極顯著的影響到產婦對醫院服務品質的評價。（3）產婦哺乳意向、產後照護品質、醫護人員哺乳支持度三者之間，有顯著的相關。（4）產婦人口學變項－生產方式、胎次、前次生產醫院，與施行母嬰同室情形、哺乳方式之間有顯著的關聯。（5）不同群組（初產婦與經產婦、自然生產與剖腹生產、24小時母嬰同室與非24小時母嬰同室、純母乳哺餵與非純母乳哺餵）對本研究理論之結構方程模式，有顯著性的差異。

關鍵字

母嬰親善醫院 ； 醫療服務品質 ； 忠誠度 ； 母嬰同室 ； 母乳哺餵 ； 結構方程模式 ； 多群組分析

並列摘要

After the implementation of National Health Insurance, the competition in medical industry has become more intense day by day. Besides reinforcing medical facilities and technologies, hospitals attach more importance to quality of medical service, expecting to increase the clients’ satisfaction and loyalty, and promoting the hospital’s operating performance further. Baby-friendly hospital authentication is the policy that Department of Health has tried to carry out with great exertion in recent years. It hopes to make breastfeeding a conventional medical care environment via the execution of ten major measures, and give a baby the best start of life. The research put forward a theoretical model, explained the relationships among a postpartum woman’s inclination of breastfeeding, the postpartum care quality, and the medical and nursing staff’s support degree of breastfeeding in a baby-friendly hospital, as well as their influences on the hospital’s service quality and the postpartum woman’s loyalty; also, it analyzed the differences of varied groups of demographic variables on the entire theoretical model, with the expectation to understand how the baby-friendly hospital policy affects the medical service quality and the postpartum woman’s loyalty. The results can be provided as the reference of policy promotion for health departments, hospitals and clients further.

The research aimed at an indicator hospital that pursues the baby-friendly hospital policy in Central Taiwan, took the women that just gave birth to a baby and were hospitalized temporarily as subjects of test, retrieved 210 copies of questionnaire in total, and tested and verified the research model through statistic methods of Descriptive Statistics Analysis, Chi-Square Test, Structural Equation Modeling, and Multiple-Group Analysis. The research findings are as follows: (1) The hospital’s service quality and the postpartum woman’s inclination of breastfeeding have a significant influence on the postpartum woman’s loyalty; (2) The postpartum care quality noticeably affect the postpartum woman’s evaluation of the hospital’s service quality; (3) The postpartum woman’s inclination of breastfeeding, the postpartum care quality, and the medical and nursing staff’s support degree of breastfeeding are obviously correlated; (4) The postpartum woman demographic variables—mode of delivery, parity, the hospital of previous delivery, have a conspicuous correlation with the condition of executing rooming-in and the feeding method; (5) Different groups (Primipara and Multipara, vaginal delivery and caesarean delivery, 24-hour rooming-in and not-24-hour rooming-in, and exclusive breastfeeding and non-exclusive breastfeeding) have a remarkable difference on the structural equation modeling of the research theory.

並列關鍵字

Baby-friendly hospital ； medical service quality ； loyalty ； breastfeeding ； rooming-in ； Structural Equation Modeling ； Multiple-Group Analysis

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