目標：以系絡觀點探究住院中與出院後病人滿意度其因素結構的測量恒等性；進而比較住院中與出院後病人滿意度評價之差異。 方法：採用THIS住院滿意度量表，針對同一期間住院病人實施住院中與出院後滿意度測量，以住院中樣本 (n＝1128) 進行探索性因素分析，萃取滿意度因素；再採平衡樣本設計，從全部住院中樣本隨機抽取685份與出院後樣本 (n＝641) 使用多樣本結構方程模式進行驗證性因素分析，檢驗滿意度之因素恒等性，最後則以效果量比較住院中與出院後滿意度之差異。 結果：獲得住院滿意度5因素結構，累積解釋變異量72.8%；兩個樣本之因素負荷量介於.78-.92之間，具因素恒等性；住院中病人滿意度高於出院後，具統計上 (p＜.001) 與實務上 (Cohen's d) 的顯著性差異，效果量介於.46-.71之間，屬中等程度差異。 結論：實證資料顯示實體環境與社會系絡會影響住院滿意之態度與評價，住院中與出院後的病人滿意度知覺呈顯著性差異，服務滿意的測量應重視構念效度以及測量可能的偏誤。

Objectives: The purpose of this study was to find out the measurement invariance of satisfaction factor structure of hospitalized and discharged patients and to compare the differences of satisfaction assessment between them. Methods: THIS questionnaire was used to measure patient satisfaction before and after discharge in the same interval. We selected 1128 hospitalized patients for exploratory factor analysis to get the satisfaction factor. Confirmatory factor analysis was performed among 685 hospitalized random patients and 641 discharged patients, using multi-group structural equation modeling to test the factorial invariance of satisfaction. We compared effect size between hospitalized and discharged patients’ satisfaction. Results: Five factor structures were found in the hospitalized patient satisfaction, which explained 72.8% of the total cumulative variance. Factor loading of the two groups was between 0.78 and 0.92 with factorial invariance. Hospitalized patient satisfaction was higher than discharged patient satisfaction (p<0.001, Cohen’s d). Effect size had a medium different level between 0.46 and 0.71. Conclusions: Physical environment and social context affect hospitalized patient satisfaction. Satisfaction perception between hospitalized and discharged patients was significantly different. Construct validity and biases should be assessed in measuring service satisfaction.