民眾公平觀感與民眾滿意度之關連：以台灣全民健保政策為例

• Main Author: 黃汎如
• Language: 中文
• Published: 國立政治大學
• Subjects: 民眾滿意度; 新公共管理; 程序正義; 實質正義; citizen satisfaction; New Public Management; procedural justice; substantive justice
• Online Access: http://thesis.lib.nccu.edu.tw/cgi-bin/cdrfb3/gsweb.cgi?o=dstdcdr&i=sid=%22G0095256016%22.

有鑑於八０年代新公共管理(NPM)的興起對公共行政帶來重大的影響，其顧客導向的主張，刺激了顧客滿意度調查在公部門廣泛的應用。然而回顧過去公私部門重要的民眾滿意度調查，發現評估指標幾乎都著重在效率、效能面，而公共行政引以為本的公平價值卻少見探討。因此，本研究選取對人民影響最基本但重大的全民健保政策為個案，嘗試建構一個兼顧效率與公平面的民眾滿意度模型，並將焦點置於公民公平觀感與滿意度之間關連性的探討。在資料的蒐集上，採用國家衛生研究院「衛生醫療體系優先順序之制定的研究」於2007年12月1日至12月24日進行的電話訪問調查，經扣除遺漏值後，共有2478份樣本。本研究所建構的民眾滿意度ordered probit模型以「健保滿意度」為結果變項，解釋變項則包含了基本人口社經背景、以及效率效能面和公平面的指標。經實證結果發現，過去一直被強調的效率效能指標對健保滿意度確實產生顯著影響，但民眾對健保政策的主觀公平觀感也被證實與滿意度有顯著關連；換句話說，如果政府進行民眾滿意度調查時，未能含括公平面指標，則其所獲得的資訊將不能完整表達民眾的心聲。但本研究亦發現公民對健保政策以外的公平性態度並未顯著的影響健保滿意度，因此，民眾滿意度調查中測量公平觀感必需具有明確的政策背景。 === In the past three decades, new public management (NPM) has a great impact on the field of public administration. Among the impacts, “customer orientation” is the most influential one. For the purpose of evaluating citizen satisfaction on government services, public agencies begin to utilize the Customer Satisfaction Survey (CSS) mainly designed and administrated by business managers. However, after reviewing the content of the CSS questionnaires, we find that the emphasizing values behind the CSS are efficiency and effectiveness rather than equality, which is sometimes the main value behind public service delivery. Whether value of equality will influence citizen’s level of satisfaction is the main research question of this thesis. We take Taiwan’s National Health Insurance (NHI) as a case study, and utilize a citizen survey on priority setting of the NHI from the National Health Research Institutes in late 2007 as the secondary data. The dependent variable of our citizen satisfaction ordered probit model is “NHI satisfaction”, and explanatory variables including demographic backgrounds, indexes about efficiency or effectiveness, and indexes about equality. The results show that efficiency and effectiveness have significant association with NHI satisfaction. Most importantly, the citizens’ general evaluation on the equality of NHI also has a significant impact on the NHI satisfaction. According to the results, we suggest that applying CSS into public service evaluation should include index about equality in order to capture the holistic picture of citizen satisfaction.