[[alternative]]Outpatient Experience and Patients’ Trust in Physicians and Hospitals

[[abstract]]研究背景：全民健保制度的實施，讓醫院面臨龐大之財務壓力，轉而著重於財務成本控制管理，因而可能削弱病患對醫師與醫療機構的信任感，造成醫療糾紛經常耳聞，為改善醫病之信任關係，關係行銷之概念逐漸用於醫療服務，旨在建立、強化醫病之信任關係，因此，本研究以關係行銷為理論基礎，欲了解病患就醫體驗對病患信任感之影響。研究目的：本研究旨在探討門診病患之就醫體驗對信任感之影響，以關係行銷與體驗線索之理論觀點，探究醫師與醫療機構的何種行為與做法可誘發病患之信任感，以及病患對醫師信任感與醫療機構信任感間如何相互影響。研究方法：本研究對台北市地區某一醫學中心與某一基層診所之內科門診病人，以立意取樣之抽樣方式進行結構式問卷調查，共收取400份問卷，獲取有效問卷377份，收案率94%，以SPSS 20.0版與PROCESS for SPSS 2.16版進行資料建檔分析，以中介模型檢視體驗線索、醫師信任感與醫療機構信任感之關係。研究結果：結果顯示人際線索、功能線索對醫師信任感有正向的直接影響，有形線索對醫療機構信任感有正向的直接影響。醫師信任感與醫療機構信任感間彼此會正向相互影響，又以醫師信任感影響醫療機構信任感較強。討論與建議：研究發現良好的就醫體驗可誘發病患對醫師與醫療機構的信任感，而病患的信任感在醫師與醫療機構間彼此又會相互移轉且正向影響。建議在醫師方面，可在跟病患解釋、討論病況與疑慮部分多加強，以達病患之就醫期待，在醫院方面，應著手改善病患就醫等候時間的說明，以降低病患等候之不耐。[[abstract]]Background: The implementation of The National Health Insurance (NHI) of Taiwan make the hospital face incredible financial difficulties. That is why the hospital start to focus on financial cost control and management, which may weaken the patient trust in physicians and medical institutions, and cause many medical disputes. To improve the trust between physician-patient relationship, the concept of relationship marketing is used in medical services gradually, which is aim to establish and strengthen the trust between physician-patient relationship. Thus, this study is based on the theory of relationship marketing, and understand the effect of outpatient experience on patient trust.Objectives: The purpose of the study is to investigate the effect of outpatient experience on patient's trust. Using the theory of relationship marketing and experience clue, to explore what behavior and practice in physicians and medical institutions can induce patient trust, and the interaction between the trust in physicians and the trust in medical institutions.Method: The study conducts via purposive sampling with structured questionnaire which is collected from outpatients of the medical department of a medical center and a clinic in Taipei City. A total of 400 questionnaires were received, and 377 questionnaires (94%) are valid. The data is archived and analyzed by SPSS 20.0 version and PROCESS for SPSS 2.16 version, and using mediation model to investigate the relationship among experience clue, the trust in physicians and the trust in medical institutions.Results: It is found that humanic clues and functional clues have positive direct effect on the trust in physicians. Mechanic clues have positive direct effect on the trust in medical institutions. Besides, the trust in physicians has positive interaction with the trust in medical institutions, and the effect of the trust in physicians is stronger than another one.Conclusion: Findings show good outpatient experience can induce patient trust in physicians and medical institutions, and patient trust in physicians and medical institutions can be mutual transfer and has positive effect on each other. Therefore, on the physicians’ side, improving the discussion and explanation on patients’ condition, to meet patients’ expectation. On the medical institutions’ side, informing waiting time clearly, to reduce the situation that patients wait impatiently