基層醫師與民眾之服務品質認知落差分析

Analysis of Service Quality Gaps between Primary Care Physicians and Patients

蔡文正(Wen-Chen Tsai) ； 龔佩珍(Pei-Tseng Kung) ； 翁瑞宏(Rhay-Hung Weng) ； 石賢彥(Hsein-Yen Shih)

《醫務管理期刊》 5卷4期 (2004/12) Pp. 385-402

https://doi.org/10.6174/JHM2004.5(4).385

摘要

目的：以服務品質模式為理論基礎，探討民眾與醫師對醫療品質認知與滿意度之差異，分析應優先改善的服務品質，並提供提升醫療品質與病患滿意度之改善方法與建議。
方法：本研究乃以中台灣地區民眾與基層診所醫師為研究對象，民眾依各層級醫院領藥號碼採隨機系統抽樣並採用訪員面訪的方式進行問卷，而醫師部分則採用郵寄問卷的方式。服務品質屬性設計上，主要以PZB的服務品質構面為理論基礎設計問卷。總計民眾部分有效問卷共1148份，醫師部分之有效問卷共254份。在分析方法上，除描述性分析外，另採用重要性／績效分析法(Importance-Performance Analysis)來進行資料分析。
結果：醫師與民眾在品質重要性認知上與品質滿意度認知上皆有差異。重要性方面，醫師對「用藥解說」與「候診時間」之重要性低估較多，但是對「就醫及諮詢方便性」與「醫師看病態度」高估較多。在滿意度方面，醫師幾乎皆高估民眾滿意度，其中以「就醫及諮詢方便性」與「病情解說」醫師高估較多。另外，對於需「迫切改善」之品質項目民眾與醫師之認知有顯著落差，其中「護士與藥師之服務態度」與「用藥解說」為民眾認為基層醫師應優先改善的項目，但是基層醫師卻無此認知。
結論：基層醫師與民眾對醫療服務品質認知，在「品質缺口一」上，醫師對民眾之品質期望存在認知差異；在「品質缺口五」上，多數項目民眾滿意度低於期望。對部分服務品質民眾顯示醫師應優先改善，但是醫師卻不瞭解其顧客之需求，醫師應定期瞭解民眾對服務品質之期望與滿意度認知，以作為改善之方向。

關鍵字

品質落差 ； 服務品質模式 ； 基層醫師 ； 服務品質 ； 重要性／績效分析

並列摘要

Objectives: According to service quality model, this study investigated the gaps of perceptions and satisfaction of health service quality between patients and physicians, and identified the order of priority of healthcare services to be improved. The study also provided the methods and suggestions to improve patients' satisfaction.
Methods: The studied population was the patients and primary care physicians in the central Taiwan. The patient samples were randomly selected according to patients' medicine-picking numbers at four-level healthcare facilities, who had experiences of visiting primary care clinics within one year. The selected patients were interviewed with structured questionnaire. The primary care physicians were surveyed by mailed questionnaire. The questionnaire was designed based on the PZB service quality model. The interviewed patient samples were 1148 and the respondent primary care physicians were 254. Besides using the descriptive statistics, this study also applied the importance-performance analysis for determining quality gaps.
Results: The gaps of perceptions of quality importance and of quality satisfaction existed between primary care physicians and patients. In the aspect of importance, physicians often underestimated the importance of ”medication explanation” and ”waiting time”, but they greatly overestimated the importance of ”convenience of seeking medical advices” and ”physician's attitudes”. In the aspect of satisfaction, physicians overestimated almost all patients' satisfactions for healthcare services, among which the satisfactions of ”convenience of seeking medical advices” and ”explanation of patients' condition” were more overestimated. In addition, it was different between physicians and patients that the healthcare qualities needed to be more concentrated to improve. Patients thought ”nurses' and pharmacists' service attitudes” and ”medication explanation” were the concentrated items for improvement but physicians did not have the same perceptions.
Conclusion: On the ”quality gap one”, the perceptions of service importance for primary care physicians differed from patients. On the ”quality gap five”, the patients' satisfactions were lower than patients' expectancy. Patients revealed to improve some service qualities but physicians did not realize them. Primary care physicians need periodically to investigate the perceptions of patients' expectancy and satisfaction in healthcare services for continuous quality improvement.

並列關鍵字

Quality Gap ； Serivce Quality Model ； Primary Care Physicians ； Healthcare Quality ； Importance-Performance Analysis

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