目的:面對多變且競爭的現代醫療場域,滿足社會大眾的醫療需求、提高醫療服務品質以及因應醫療財務的增長與可能的危機,無疑是相當受社會大眾、醫療機構與政府部門重視的社會與健康議題。本研究之目的,為了解影響台中市某地區受訪民眾對於醫護人員工作環境、醫療服務品質與健保財務負擔及滿意度之因素以及之間的可能關聯。方法:本研究為橫斷式研究。採便利取樣及現場發卷進行問卷調查。共發放900份問卷,有效問卷回收率為92.7%。問卷資料進行量表信度與效度分析;次數分配、平均數等描述性統計分析;獨立樣本t檢定、單因子變異數分析(ANOVA)、皮爾森相關分析及複迴歸等推論性統計分析。結果:受訪民眾對於醫護人員「工作環境」、醫療「服務品質」、健保「財務負擔」及「財務滿意度」,分別會因為性別、年齡、教育程度、婚姻狀況、個人每月平均收入與職業等個人特質的不同而有顯著差異。受訪者對於醫療「服務品質」的認知與「健保負擔」(r=0.327,p<0.01)及「財務滿意度」(r=0.429,p<0.01)之間皆呈顯著正相關。此外,受訪者「健保負擔」認知對醫療「服務品質」認知具有顯著正向影響(β=0.328,P<0.001)。結論:受訪民眾能認知醫療人員工作情境確實不佳,也肯定整體醫療服務品質;然而,對於增加健保財務負擔及醫療財務支出的滿意度,傾向同意的態度則明顯偏低。在社會大眾認為醫療人員工作環境不佳,也不容易增加民眾的健保財務負擔的情況下,建議政府相關部門仍應多關注醫療人員工作制度的改善;也應積極思考並提出節制醫療資源使用的可能方式與對策。
Background: This purpose of this study is to understand the factors and relationships that influence respondents' of Taichung City to the health care professionals' work environment, quality of medical services and financial burden and satisfaction of National Health Insurance. Methods: This study collected data with structural questionnaire by convenience sampling method. There were 900 subjects (valid returned rate was 92.7%) invited in this study. This study performed descriptive statics, variance analysis and linear regression analysis to examine the related factors influencing the respondents' perceptions. Results: The subjects' perceptions in health care professionals' "working environment", "medical service quality", "financial burden" and "financial satisfaction" of NHI were vary significantly due to gender, age, education level, marital status, personal average monthly income and occupation. Respondents have a significant positive correlation between the cognitive aspects of "medical service quality", "financial burden" and "financial satisfaction" of NHI. Conclusions: The respondents were able to recognize that the medical professional's working environment was poor indeed, and also confirmed the quality of medical services; however, the attitude of agreeing to the increase in the financial burden of health care and medical financial expenses was significantly lower.