[[alternative]]An analysis of medical service quality by using SERVQUAL model

[[abstract]]背景與目的隨著市場資本化的興起，市場的競爭日趨激烈，同時加上民眾的就醫意識崛起，對於醫療服務的需求已經不是在量的滿足，質的追求更是民眾所追求的目標，因此在此氛圍下，醫院為了獲得市場的競爭優勢，無不積極朝向品質提升的管理目標邁進，因此提升醫療服務品質成為一個主要的策略。故本研究主旨以PZB服務品質模式為理論基礎，探討病患對於五個醫療服務品質構面重要性的衡量對容忍區間寬度、容忍區間高度之間的影響，瞭解門診病患對醫療服務品質的重視程度與渴望和最低可接受服務水準，並針對病患認知較為重要的醫療服務品質構面提出提升院內門診醫療服務品質參考之方案。研究方法本研究利用橫斷性研究設計，使用SERVQUAL量表進行問卷發放，自2015年12月至2016年1月期間於台北市某區域醫院，採取隨機抽樣的方式，採用結構式問卷，內容主要包含有形性、可靠性、確實性、回應性、同理心五個服務品質構面，共計28題題項，總共發放600份問卷，有效問卷共552份，有效樣本回收率為92％。研究結果研究結果顯示門診病患對於「有形性」重要性與容忍區間寬度，呈負相關；而「有形性」重要性與容忍區間高度，呈正相關。而「可靠性」、「確實性」、「回應性」、「同理心」重要性與容忍區間高度，皆呈正相關。代表當病患對此服務構面越重視時，其容忍區間的範圍越小，從結果得知醫院更應該朝有形性構面的品質管理發展，增加資金於設備儀器，以提升醫療服務品質。另外藉由獨立T檢定、ANOVA分析的結果，性別、年齡、婚姻狀態、忠誠度皆會影響病患對醫療服務品質的要求，此也可以做為醫院提供醫療服務的參考水準之一。討論研究結果發現，當病患對於服務品質構面越重視時，其容忍區寬度會越窄、容忍區間高度會越高，這與大多數文獻結果一致，而本研究結果以有形性構面重要性對於容忍區間影響結果最為明顯，有形性的構面內容包括醫院的科別分類與標示指引、空間配置是否洽當（掛號櫃台、走道、診間、電梯）、實體設備、工作人員的服裝儀態以及醫院交通位置是否便利，若醫院內部能有效加強有形性構面的資源投入，不僅民眾對於醫療服務品質滿意度會提升，更可讓台北市某區域醫院增加市場競爭力及獨特性，成為民眾信賴就醫的區域醫院。[[abstract]]IntroductionAccompanied with the capitalization of the medical service, the competition of medical markets becomes more and more sharp. On the other hand, the patient pays more attention on the quality of medical services provided. And thus, most medical providers adopt the strategy by enhancing the medical quality to reinforce its competitive advantage in the medical market. MethodsIn this paper, we use the questionnaire of SERVQUAL based on the PZB gap model to measure the impact of tangible, reliability, assurance, responsiveness and empathy on the height of tolerance zone and width of tolerance zone. Derived from results of the analysis on the patient’s perspective, this paper also provides some suggestions for the promotion of service quality for hospital. The survey conducted during December, 2015-January 2016. The sample is drwan from some district hospitals located in Taipei. Results:The results find that the tangible keeps a negative impact on the width of tolerance zone. In contrast, the four factors of reliability, assurance, responsiveness and empathy have positive relationship with the height of tolerance zone. The results implies that the management authority should focus on the promotion of service quality by investing more medical equipment as the quality factor (criterion) of the tangibility is highly value. Discussion:We also use t test and ANOVA to investigate the relationship between the socio-economic factors and the demand of quality. As the quality factor of tangibility contains the item of questionnaire involving the appropirateness of space allocation, infrastructure, the dress of the employee, and the traffic convenience of the hospitals, this paper suggests that the management authority also needs to focus on the improvement of these items