運用服務品質模式探討『以顧客為中心』之醫療服務

Abstract

背景: 衛生福利部於2014年公布103國人十大死因統計結果顯示，以慢性疾病為主，位居國人十大死亡第一名為惡性腫瘤(28.8%)，且兩性首要癌症死因均為肺癌，而位居國人十大死亡第二名是心臟疾病(16.9%)，現今國人罹患冠狀動脈疾病與癌症的人口逐年增加，且正因全球化快速變動的經濟環境中，醫療需求者對醫療服務品質的要求也愈來愈高，因此以顧客為導向的理念，已逐漸由一般服務業擴及至醫療保健服務機構。 目的:利用 PZB服務品質模式發展之SERVQUAL問卷，探討病患與家屬對醫療服務品質之期望與實際感受到的認知差異程度，以及對於醫療服務品質重視程度，進而深入瞭解病患與家屬對醫療的需求、認知、信賴度與就醫滿意度，以全人照護之理念，以作為改善胸腔與心臟內科醫療照護品質之參考，達成全人醫療照護服務目標。 方法:本研究採用SERVQUAL問卷填答方式，主要對象為胸腔內科與心臟內科病患與家屬。問卷施測時間自2015年1月6日至2015年3月13日，且收案方式為一對一說明填寫「問卷研究受訪者說明及同意書」與本研究服務品質衡量問卷，因此沒有無效問卷，最後問卷實得有效問卷為200份，其問卷回收率為100%。 結果:本研究結果顯示，在服務重視程度( E )與服務知覺達成程度( P ) 方面，其Cronbach’s α 皆為大於0.90，表示具有良好的信度。在整體受試者包含心臟內科與胸腔內科之病患與家屬所期望的醫療服務構面中，皆以確保性為最高分數。在整體受試者之病患與家屬所感受的醫療服務構面中，以確保性為最高分數，最低分數為有形性。 結論與建議: 服務品質構面之確保性，為病患與家屬認為心目中最好的醫院 應具備的服務品質構面，說明了醫護人員專業態度與自身敬業精神的重要性。除此之外，為提昇服務品質與創造優質的就醫環境，除了擬定標準化的作業程序及持續的教育訓練外，同樣地，亦需適時給予醫療相關人員激勵與重視病患與家屬的意見。

Background: The Ministry of Health and Welfare announced the top ten causes of death in 2014, the statistics showed the first ranked were the chronic diseases and the mainly death were the malignancy tumor (28.8%), and the primary cause of cancer death were the lung cancer with male and female. The second death ranked were the heart disease (16.9%). Today’s people suffering from coronary artery disease and cancer population increases by every year, and because of the rapidly changing global economic environment, the medical demanders requirements for medical service quality are always rising, so the customer-centered philosophy has from gradually services extend to the general health care services. Objective: Use SERVQUAL questionnaire PZB service quality model development, and to explore the patients and their families with the quality of medical service expectations and actual experience of the quality medical services, although to understand the demand for medical care, cognition, reliability and satisfaction with the medical care. We can to improving the chest medicine (respiratory) and cardiology of health care quality and to reach the target of the holistic health care. Methods: This study used a questionnaire of the SERVQUAL model, the main target of chest medicine and cardiology patients and their families. The questionnaire measured time by January 6, 2015 to March 13, 2015. This study were closed the case one way to understand and filled in 'research questionnaire respondents explained and consent' of the present study a questionnaire to measure the quality of service, so no invalid questionnaires, the last questionnaire actually gets 200 valid questionnaires, the response rate was 100%. Results: The results of this study showed that the degree of attention in service (E) to reach a level of perception and services (P) is concerned, Cronbach's α are all greater than 0.90, indicating good reliability. In the overall subjects, the patients and families of the desired service services dimensions with the highest score were the assurance dimension. In the overall subjects, the patients and families of the experienced service services dimensions with the highest score were the assurance dimension and the lowest score were tangible dimension. Conclusions and Recommendations: The assurance dimension of the service quality were the imporant facor with the patients and families. That’s mean the importance of assurance dimension were professional attitude and professionalism of the medaical staff. In addition, to improve service quality and create high-quality environment for medical treatment, not only to develop standardized operating procedures and continuing educational training, but also be given timely encourage to medical staff and pay attention to the views of patients and their families.