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題名:醫療服務品質與病患滿意度非線性關係的探討與應用
作者:陳秀珠
校院名稱:國立臺灣大學
系所名稱:商學研究所
指導教授:黃崇興
林能白
學位類別:博士
出版日期:2003
主題關鍵詞:病人認知的服務品質期望服務的不相符程度整體滿意度顧客滿意指標模式服務品質管理矩陣customer satisfactionperceived qualitydisconfirmationutility-oriented modelpatient satisfaction modelstrategic management map
原始連結:連回原系統網址new window
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醫院管理者所面臨的是醫院間愈趨激烈的競爭、經營成本不斷上升、政府法令限制更加嚴苛、健保不斷推出醫療支出控制措施、消費者意識抬頭等諸多考驗,為了醫院的永續經營,不論各種環境因素如何變化,提高醫療服務品質、提供令消費者滿意的醫療服務、確保病患下一次再接受服務的意願、維持長久且良好的醫病關係,才是醫院經營的正道。可是醫療服務是極具專業性的,除了服務品質之外,不論顧客是否有能力作判斷,醫療服務提供者更要秉持專業道德提供病患優質的醫療技術品質。只是在消費者意識抬頭、顧客滿意優先觀念的倡導下,醫院管理者是否在品質管理策略上,容易偏重於服務品質的提升,造成資源分配的挪移,忽略了醫療技術品質的提升。根據實務上的經驗,以及多位學者已有的研究推論,服務品質與顧客滿意程度之間的關係,可能存在著效用遞減的現象,如果在醫療服務品質與病人滿意程度之間的關係,也存在著同樣的現象,則將有助於醫院管理實務上,追求資源取捨與使用的最適化,進而提升醫院的競爭優勢。
有鑑於此,本研究試圖驗證病人對於「病人認知的服務品質」、「期望服務的不相符程度(Disconfirmation)」、「整體滿意度」之間的非線性關係。所以,本研究採用美國顧客滿意指標模式(ACSI Model)與歐洲顧客滿意指標模式(ECSI Model)作為門診顧客滿意度問卷發展的基礎,依據其模式中的各項latent variable作為問卷構面,依此發展出衡量指標 ( measurement variable ),其中 「病人認知的服務品質」(perceived quality)是採用PZB三位學者所提出的服務品質五項構面以及SERVQUAL的問項來發展各項醫療服務屬性。然後以一家醫學中心為研究標的,對樣本醫院發展出衡量醫療服務品質與門診病患滿意度的問卷,以進行研究模型的實證工作。
研究發現,「病人認知的服務品質」與「整體滿意度」之間存在非線性關係,而且是凹函數關係,表示當認知服務品質不斷提升,對於整體滿意度的影響將逐步減弱,在管理實務上,應做管理資源配置的調整,不需要將組織資源無限制的投入於改善各項服務品質,而是應著重於服務水準較低的項目,甚至將資源優先投入醫療技術品質的提升。此外, 依照本研究的經驗得知,ACSI或ECSI適合本土醫院用來發展顧客滿意度衡量系統,而且該顧客滿意度模式可利用PLS演算法,估算模式中各隱藏變數(latent variable)的權重,而透過此權重可估算每一隱藏變數的分數,有利於醫院本身在進行品質改善活動後,對於品質管理績效的衡量。又透過這組權重,也可以產生管理矩陣圖,將認知服務品質的衡量變數依照目前的分數與重要性,在服務品質管理矩陣上找到落點,找出服務品質項目改善的優先順序,對於品質管理資源分配決策極具意義。
There is growing managerial interest in customer satisfaction as a means of evaluating quality. High customer satisfaction is highly believed to be correlated with firm’s future profit. Literature review revealed that customer satisfaction is directly affected by perceived quality and the level of disconfirmation. Some researchers proposed the utility-oriented model to depict the relationships between these constructs. Therefore, understanding the complexity of the relationships between satisfaction and its antecedents and consequences has become a key strategic imperative for most managers.
For investigating the asymmetric and non-linear nature of the relationship among perceived quality, disconfirmation and overall satisfaction, predictions are developed and tested empirically using data from a medical center (n=390). The results show that (1) overall satisfaction displays diminishing sensitivity to patient perceived quality. (2) when ideal expectation suddenly were disconfirmed positively, then it would salient and affect overall satisfaction. Moreover, after using PLS as the method to estimate the patient satisfaction model , there were estimative score of latent variables and produced the strategic management map. It would be helpful to understand the condition under which hospital should allocate resource to eliminate negative performance first and then focus on increasing performance in the positive direction.
一、 中文部分
王美秀,「品質屬性衡量之整合模式」,中原大學工業工程學系博士論文,民國八十九年。
台灣醫務管理學會THIS之「病患滿意度實施辦法」,民國九十年九月。
朱永華,「醫院服務知覺品質與病患滿意度之關係研究」,成功大學企業管理研究所碩士論文,民國八十四年。
江清泉,「醫院門診服務品質之改善與探討---以台大醫院為例」,國立台灣大學商學研究所碩士論文,民國九十一年。
李錫銘,「顧客滿意度調查」,品質月刊,民國九十一年四月。
巫俊明、王愛義、張榮華在職醫護人員<輻射安全與防護>推廣課程及相關認知與迷思概念研究,元培學報,5,153-176,民國八十七年。
沈振德,「對於某大學醫院介面服務品質調查機制之研究」,台灣大學商學研究所碩士論文,民國九十一年。
衫本辰夫 著,盧淵源 譯,「事業、營業、服務的品質管制」,中興管理顧問公司,民國七十五年。
洪世全,「服務品質、服務價值與顧客滿意度的關係」,台灣大學商學研究所碩士論文,民國八十四年。
黃俊英,行銷研究─管理與技術,華泰書局。
陳文華、徐聖訓、許蕙萍,「顧客滿意度調查----以某銀行為例」。民國九十一年。
陳文華教授網站,140.112.110.128。
陳昭良,「影響服務期望水準因素之探討---以醫院及速食店為例」,台灣大學商學研究所碩士論文,民國八十一年。
陳敏君,「急診病人及家屬滿意度調查與服務品質相關因素探討」,領導護理,第二卷第二期,民國八十七年。
翁崇雄,「評量服務品質與服務價值之研究---以銀行業為實證對象」,國立台灣大學商學研究所博士論文,民國八十二年。new window
張秀如、陳光和,「以滿意度調查探討門診病患對服務品質的主觀感受」,醫院,第32卷第一期。
張睿詒、江東亮,以風險校正模型探討控制全民健康保險醫療費用之研究,行政院衛生署委託研究計畫,民國八十七年。
張睿詒,運用風險校正公式評估論人計酬支付制度實施之可行性,行政院衛生署委託研究計畫,民國八十八年。
黃素丹,「門診病患滿意度調查與服務品質相關因素探討」,醫院,第30卷第二期。
許惠萍,「顧客區隔、滿意度與關係管理整合運用之實證研究」,台灣大學商學研究所碩士論文,民國九十年。
楊志良,保險支付方式變遷下醫療機構住院服務策略因應之探討行政院衛生署委託研究計畫,民國八十七年。
楊錦洲,中央健康保險局中區分局推行TQM體系之輔導─以國品獎之評鑑項目為基礎,行政院衛生署八十九年度委託研究計畫,民國九十年。
蕭鏡堂,市場研究,民國七十八年。
羅宣、楊美雪、紹文逸,長期照護機構選擇屬性之研究─以知覺風險為市場區隔基礎,台灣衛誌,民國九十年;20(5):381-394。new window
藍采風、廖榮利,1990社會醫療學,三民書局。
盧瑞芬、謝啟瑞,2000,醫療經濟學,學富文化事業有限公司。
盧瑞芬、蕭慶倫,2001,台灣國民醫療衛生保健帳戶的建立,經濟論文叢刊,29(4),547-576。new window
蘇喜、李敏禛、劉嘉玲,「醫院看診等候滿意度之研究---以某醫學中心家庭醫學科為例」,醫療品質雜誌,第一卷第一期,民國八十七年。
財團法人醫院評鑑暨醫療品質策進會網站,www.tjcha.org.tw
「顧客滿意度調查系列(1)、(2)、(3)」,現場與管理,第28卷第一期,民國九十一年。
二、 西文部分
Adam Smith (1776), The Wealth of Nations.
Anderson, E. , 1998, “Customer satisfaction and word-of-mouth”, Journal of Service Research, Vol. 1, pp1-14.
Anderson E., M. Sullivan, 1993, “ The Antecedents and Consequences of Customer Satisfaction for Firms”, Marketing Science, Vol. 12, Spring, pp125-143.
Barach, J. A.(1968), “Risk Style and Consumer Choice”, Southern Journal of Business, Vol. 3.pp. 129-144
Bauer, R. A. (1960), ”Consumer Behavior as Risk Taking”, In R.S. Hancock(Ed.), Dynamic Marketing for A Changing World, pp. 389-398, Chicago: American Marketing Association.
Bettman J. R. (1972), “Perceived Risk: A Measurement Methodology and Preliminary Findings”, In M.Venkatesan (Ed.), Proceedings: 3rd Annual Conference, pp. 394-403, Chicago: Association for Consumer Research.
Bettman J. R. (1973), ”Perceived Risk and Its Components: A Model and Empirical Test”. Journal of Marketing Research, Vol. 10, pp. 184-190
Bettman J. R. (1975), “Information Integration in Consumer Risk Perception: A comparison of Two Models of Component Conceptualisation”, Journal of Applied Psychology, Vol. 60(3), pp. 381-385.
Bitner M. J., 1990, “ Evaluating Service Encounters : the effect of physical surroundings and employee responses”, Journal of Marketing, No. 54, Apr., pp69-82.
Bolton R. N., James H. Drew, 1991, “ A Multistage Model of Consumers’ Assessment of Service Quality and Value”, Journal of Consumer Research, Vol. 17, Mar., pp375-384.
Bordley R. F., 2001, “ Integrating Gap Analysis an Utility Theory in Service Research”, Journal of Service Research, May, pp300-309.
Boulding W., Kalra A., Staelin R. , Zeitham V. A., 1993, “ A Dynamic Process Model of Service Quality,” Journal of Marketing Research, Vol. XXX, Feb., pp7-27.
Boulding W., Kalra A., Staelin R., 1999, “ The Quality Double Whammy”, Marketing Science, Vol.18 , No. 4, pp463-484.
Brown Gary C., Melissa M. Brown, Sanjay Sharma, 2000,“ Health Care in the 21st Century : Evidence-Based Medicine, Patient Preference-Based Quality, and Cost Effectiveness”, Quality Management in Health Care, Vol.9, No.1, pp23-31.
Brown H. Shelton, 2001, “ Income, Location, and the Demand for Health Care from Public, Nonprofit, and For-Profit Hospitals”, Journal of Health Care financing, Vol. 27, No. 4, pp24-38.
Buell, Victor P., 1984, “Marketing Management: A Strategic Planning Approach”, McGraw-Hill.
C.A.Kulp & John W. Hall (1980), “Casualty Insurance” 4th edition, pp. 3.
C. Arthur Williams & Jr George L. Head & Ronald C. Horn & G. William Glendenning (1981), “Principles of Risk Management and Insurance” Vol.1.2. 2nd edition pp. 55-66
C. Arthur Williams & Richard M. Hein (1981), “Risk Management and Insurance”, pp. 4.
Cardozo R. N., 1965, “ An Experimental Study of Customer Effort, Expectation, and Satisfaction”, Journal of Marketing Research, Vol.2, Aug., pp244-249.
Carolyn M. Clancy; 1999 “ Consumer Preferences: Path to Improvement ?”, Health Services Research, Vol. 34, No. 4, pp807-811.
Caruana A., Money A. H., Berthon P. R.,2000, “ Service Quality and Satisfaction─the moderating role of value “, European Journal of Marketing, Vol. 34, Iss. 11/12, pp1338-1353.
Churchill G. A. Jr., Surprenant C., 1982, “ An Investigation into the Determinants of Customer Satisfaction “, Journal of Marketing Research, No. XIX, Nov., pp491-504.
Cox , D F. & S.J. Rich(1967), “Perceived Risk and Consumer Decision Making-The case of Telephone Shopping”,, Journal of Marketing Research , Vol. 4. No.3 , pp. 32-39
Cronin J. J., Taylor S. A., 1992, “ Measuring Service Quality : a re-examination and extension “, Journal of Marketing, No. 56, July, pp55-68.
Cronin J. J., Taylor S. A., 1994, “ SERVPERF versus SERVQUAL : reconciling performance based and perception based-minus expectation-measurements of service quality”, Journal of Marketing, No..59, Jan, pp125-131.
Deruyter K., Bloemer J., Peters P., 1997,” Merging Service Quality and Service Satisfaction : an empirical test of an integrative model “, Journal of Economic Psychology, Vol. 18, No. 4, pp387-406.
Fornell, C., M.D. Johnson, E.W. Anderson, J. Cha and B. E. Bryant, 1996,”The American Customer Satisfaction Index : Nature, Purpose, and Findings.” Journal of Marketing, Vol. 60, Oct. pp7-18.
Garvin, David A.,1983, “Quality in the line”, Harvard Business Review, pp65-75.
Garvin, David A., 1984, “What does ‘Product Quality’ Really Mean ?”, Sloan Management Review, pp25-43.
Gronroos, Christian, 1982, “An Applied Service Marketing Theory”, European of Marketing, pp30-41.
Gronroos, Christian , 1984,“A Service quality and its Marketing Implication” ; European Journal of Marketing, pp36-44.
Hanson R., 1992, “ Determining Attribute Importance”, Quick’s Marketing Research Review, Vol. 6, Oct., pp16-18.
Haywood-Farmer, John, 1988, “ A Conceptual Model of Service Quality” ; Industrial Journal of Production Management, V8, N6, pp19-29.
Heskett, James L., 1987, “Lesson in Service Sector”, Harvard Business Review, March, pp118-126.
Iring Pfeffer (1956), “Insurance and Economic situation”, pp. 179.
Jacoby J. & L. Kaplan (1972),”The components of perceived risk”, In M. Venkatesan (Ed.), Proceeding: 3rd Annual Conference, pp. 382-393, Chicago: Association for Consumer Research.
James A. Fitzsimmons James A., Mona J. Fitzsimmons, 2001, “Service Management” ; McGraw-Hill, Inc.
Jerry S. Rosenbloom (1972), “Insurance Principles and living”, pp. 3.
John Neumann & Oscar Morgenstern (1944) ,Theory of Games and Economic Behavior.
Juran J. M., 1974, “Quality Control Handbook” ; McGraw-Hill Book Co.
Kaplan, L.,G. Szybillo & J. Jacoby(1974), “Components of Perceived Risk in Product Purchase: A Cross-validation”, Journal of Applied Psychology, Vol. 10(4), pp. 479-486.
King, Carol A., 1987, “A Framework for a service quality assurance system”, Quality Progress, pp27-32.
Kogan, N.& M. A. Wallach (1964), Risk Taking: A studying in Cognition and Personality, New York: Holt, Rinehart & Winston.
Kotler Philip,1991, “ Marketing Management─Analysis, Planning, Implementation and Control”, 7th ed., Englewood Cliffs, NJ: Prentice-Hall, Inc.
Kristensen K., A. Martensen and L. Gronholdt,2000, ”Customer Satisfaction Measurement at Post Demark: Results of Application of the European Customer Satisfaction Index methodology.” Total Quality Management, Vol.11, No. 7, pp1007-1015.
Lane, P.M., Lindquist, J.D., 1998. “ Hospital Choice : A Summary of the Key Empirical and Hypothetical Findings of the 1980s.” Journal of Health Care Marketing, Vol. 8, pp 5-20.
Lovelock Christopher H, 1991, “Service Marketing”, Prentice-Hall Inc.
MacKenzie, K. D. (1971), “An Analysis of Risky Shift Experiments”, Organizational Behavior and Human Performance, Vol. 6, pp. 282-303.
Mittal V., Ross W. T. Jr., Patrick M. Baldasare, 1998.” The Asymmetric Impact of Negative and Positive Attribute-level Performance on Overall Satisfaction and Repurchase Intensions,” Journal of Marketing, Vol. 62, Jan., pp33-47.
Oliver R. L., 1980, “ A Cognitive Model of the Antecedents and Consequences of Satisfaction Decisions “, Journal of Marketing Research, Vol. XVII, Nov., pp460-469.
Olshavsky R. W., John A. Miller, 1972, “ Consumer Expectations, Product Performance and Perceived Product Quality”, Journal of Marketing Research, Vol. 9, Feb., pp19-21.
Olson Jerry C., Philip Dover, 1979, “ Disconfirmation of Consumer Expectation Through Product Trial”, Journal of Applied Psychology, Vol. 64, Apr., pp179-189.
Parasuraman A, V. A. Zeithaml, L. L. Berry, 1990, “Delivering Quality Service”, The Free Press .
Parasuraman A , V. A. Zeithaml, L. L. Berry, 1985, “ A conceptual Model of Service Quality and Its Implications for Future Research”, Journal of Marketing, Vol.49, pp 41-50.
Parasuraman, A, V. A. Zeithaml , L. L. Berry,1988, “ Communication and Control Process in the Delivery of Service Quality”, Journal of Marketing, Vol.52, pp 35-48.
Phelps C. E., 1997, “ Health Economics”, New York, NY : Addison-Wesley Educational publishers Inc.
Robert I. Mehr & Emerson Cammack (1980), “Principles of Insurance”, pp. 20.
Rust R. T., Inman J. J., Jia J., Zahorik A., 1999, “ What You Don’t Known about Customer-Perceived Quality : The Role of Customer Expectation Distributions, “ Marketing Science, Vol. 18, No. 1, pp77-92.
Sasser, W. Earl; R. Paul Olson & D. Dayrl Wyckoff , 1978, “Management of Service Operations” ; Allyn and Bacon Inc.
Spreng R. A., Mackoy R. D., 1996, “ An Empirical Examination of A Model of Perceived Service Quality and Satisfaction”, Journal of Retailing, Vol. 72, No. 2, pp201-214.
Taylor S. A., Baker T. L., 1994, “ An Assessment of the Relationship between Service Quality and Customer Satisfaction in the Formation of Consumers’ Purchase Intentions”, Journal of Retailing, Vol. 70, No. 2, pp163-178.
Taylor S. L. , Cosenza R. M., 1999, “ A Conceptual Choice Model for Hospital Services “, Journal of Marketing Theory and Practice, Fall,pp20-32.
Thaler G., 1985, “ Mental Accounting and Consumer Choice”, Marketing Science, Vol. 4, Summer, pp199-214.
Tse D. K., Wilton P.C., 1988, “ Models of Consumer Satisfaction Formation : an extension “, Journal of Marketing Research, Vol. XXV, May, pp204-212.
Wittink D. R., Leonard R. Bayer,1994, “ The Measurement Imperative”, Marketing Research, Vol. 6, Winter, pp14-23.
Zikmund, W. G. & J. E. Scott (1973), “A Multivariate Analysis of Perceived Risk: Self-confidence and Information Source”, In S. Ward and P. Wright (Eds.), Advances in Consumer Research, Vol. 1, pp. 406-416, Chicago: Association for Consumer Research.
 
 
 
 
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