臺灣醫院評鑑制度與病人經驗及Google評價之相關性研究

Abstract

背景：評鑑是國際間公認用來評估、確保與提升醫療照護品質的評價過程，臺灣醫院評鑑制度近年來也已從過去著重醫院基礎建設等結構面要求，轉而提升至過程面與結果面的品質評估。近年來數位化與資訊公開的快速發展，Google評分成為臺灣民眾最常使用社群媒體平台，相較於傳統評鑑制度，Google評分可能成為臺灣民眾反應醫療院所就醫經驗的重要管道。 目的：探討Google醫院評分與病人住院經驗中，醫病互動以及病人滿意度之間的關係。並從各個面向來瞭解目前臺灣醫院評鑑等級與病人住院經驗中的醫病互動關係、病人滿意度以及Google醫院評分之間的關係。 研究方法：本研究之資料來源為「全民健保病人住院經驗調查問卷」中收錄9,390名病患就醫之165間醫療院所；並以網路搜尋方式收集此165間醫院的Google醫院評分，透過各項統計分析方法，探討醫病互動、病人滿意度以及Google醫院評分三個品質指標之間的關係；以及在控制醫院特徵後，醫院評鑑等級與醫病互動、病人滿意度以及Google醫院評分之間的關聯性。 研究結果：Google醫院評分與醫病互動、病人滿意度的指標有正向的相關性。不同的醫院評鑑等級在控制醫院特徵後，發現與醫病互動、病人滿意度以及Google醫院評分沒有直接的關聯性存在，僅有地區醫院在病人滿意度及醫病互動中的兩個指標上比區域醫院來的高分。 結論：Google醫院評分與醫療品質結果面中病人滿意度為一樣的概念，與醫療品質過程面之間也證實醫病互動的關係越好，民眾在醫院的Google評分上有越高分的趨勢。而在醫院評鑑等級與醫療品質的關係上，兩者可能不是單一的因果關係，需要考量到其他的影響因素。

Background: Accreditation is an internationally recognized process used to evaluate, ensure, and improve the quality of healthcare services. In recent years, Taiwan’s hospital accreditation system has shifted from focusing primarily on structural requirements such as infrastructure to emphasizing quality evaluations in terms of process and outcome. With the rapid development of digitalization and information transparency, Google ratings have become one of the most widely used social media platforms for the Taiwanese. Compared to traditional accreditation systems, Google ratings may serve as an important channel for reflecting patients’ healthcare experiences in Taiwan. Objective: To explore the relationship between Google hospital ratings and inpatient experiences, specifically in terms of doctor–patient interaction and patient satisfaction. Furthermore, the study examines the relationship between hospital accreditation levels, inpatient doctor–patient interaction, patient satisfaction, and Google hospital ratings from multiple perspectives. Methods: The data source for this study is from "National Health Insurance Inpatient Experience Survey," which includes 9,390 patient responses from 165 healthcare institutions. Google ratings for these 165 hospitals were collected through online search. Statistical analyses were conducted to investigate the relationships among doctor–patient interaction, patient satisfaction, and Google hospital ratings as indicators of healthcare quality. In addition, the study examined the association between hospital accreditation levels and these three quality indicators after controlling for hospital characteristics. Results: Google hospital ratings were positively correlated with both doctor–patient interaction and patient satisfaction. After controlling for hospital characteristics, hospital accreditation level was not directly associated with doctor–patient interaction, patient satisfaction, or Google hospital ratings. The only significant finding was that district hospitals scored higher than regional hospitals on two indicators of doctor–patient interaction and patient satisfaction. Conclusion: Google hospital ratings and patient satisfaction both reflect aspects of healthcare quality outcomes, and there is also a confirmed relationship between Google ratings and healthcare process quality, specifically doctor–patient interaction. In terms of the relationship between hospital accreditation level and healthcare quality, the results suggest that no single causal relationship exists, and other influencing factors should be taken into account.