本研究主要是針對某大醫院的經皮心導管穿刺術（PTCA）的患者之滿意度和醫療照護品質之探討， 並透過實施臨床路徑提高其操作之效率。 研究的設計是實驗性的non-equivalent control group。 應用大型醫院的次級資料， 由兩個世代組成各有一百五十名患者為樣本的滿意度調查。 第一世代是在實施臨床路徑以前，所有在醫院接受（PTCA）的患者（實驗組）， 經隨機抽樣選出150名為樣本。 第二世代是在實施臨床路徑以後，在醫院接受（PTCA）的所有患者（對照組）， 經隨機抽樣選出150名為樣本。 患者滿意度調查問卷的信賴度是，應用Cronbach’s Alpha 的統計分析、 T-Test、Chi-square 和多層式回歸分析來測試實施臨床路徑後的“假設”，患者有更高的滿意度， 獲得更有效率的照護及更少的未滿足事件發生。 本研究主要發現有： 一、 透過實施臨床路徑後，在五個層面中, 得到更高的患者滿意度； 當它們在控制教育、照顧型態、和醫院經驗時，它們是出院過程、醫師照護、護理照護、與醫院員工的溝通、及治療結果。 二、 實施臨床路徑是醫療照護品質的最好指標，同時也能減少住院日。 全部五個層面，患者滿意度都呈現高的R-Square值，從0.30到0.57之間， 最大的滿意度增幅為與醫院員工的溝通, 增加幅度為1.0點。 評估每位患者的成本、入院照顧程序的效率、且避免重覆臨床檢查、實施臨床路徑後，全部顯示正面性衝擊。 基於研究發現， 臨床路徑有正面性意義衝擊、醫療照護品質和患者滿意度。 本人推薦實施臨床路徑是推進醫療照護品質的最好工具之一。

This study evaluated the effect of clinical pathway implemented for Percutaneous Translumeal Coronary Angioplasty ( PTCA ) procedure on patient satisfaction and medical care quality in Taiwan. The study design was the experimental non-equivalent control group type. Secondary data from a large teaching hospital were used, consisting of patient satisfaction survey data of two cohorts of 150 patients each: one cohort treated at the hospital in the year prior to clinical pathway implementation ( experimental group ) and the second cohort, treated in the year after PTCA implementation ( non-equivalent control group ). The 150 patients had been randomly selected out of the total patients treated in each year. The reliability of the questionnaire used for patient satisfaction survey was tested using Cronbach’s alpha statistic. T-test, chi-square tests and multiple regression analysis were done to test the hypotheses that clinical pathway implementation would result in greater patient satisfaction, more efficient care, and fewer undesirable clinical events. The major findings are that (1) After controlling for education, type of caregiver, and past hospitalization experience, clinical pathway implementation was associated with higher patient satisfaction on all five dimensions tested, satisfaction with the discharge process, physician’s care, nursing care, communication with the medical staff, and the care outcomes, (2) Clinical pathwan turn predicted lower length of stay. All five models of patient satisfactioy was associated with better clinical indicators of health care quality, which in showed high R-square values, ranging between 0.30 and 0.57. the greatest increase in satisfaction score was with the communication with clinical staff, which increased by an average of 1.0 point. Estimates of costs per patient, efficiency of care procedures during hospitalization, and avoidance of duplicative clinical investigations all showed a positive impact of clinical pathway implementation. Based on the study findings, it is concluded that clinical pathways have a significant positive impact on quality of care, and patient satisfaction. It is recommended that clinical pathways be implemented for as many procedures as possible.