| Summary: | 碩士 === 國立高雄醫學大學 === 公共衛生學研究所碩士在職專班 === 90 === Abstract
This study assessed the relative importance of factors and decision behavior affecting patient’s medical care seeking behavior at Bureau of National Health Insurance Outpatient Centers, so our study aims to understand (1) patient satisfaction of service structure of medical care.(2) patient satisfaction of service process of medical care. (3) patient satisfaction of service results of medical care. (4) the moderation of predisposing factors and enabling factors. As stated above could affect patient’s medical care seeking behavior at Bureau of National Health Insurance Outpatient Centers. (5)The factor in patient satisfaction of service structure, service process and service results of medical care could predict that patient’s medical care seeking behavior at Bureau of National Health Insurance Outpatient Centers at the same time. (6)Estimating model for the probability of continually selected Outpatient Centers for medical care.
To have the data covering a wide variety of information , the current study surveyed the patients of Taichung & Kaohusiung Outpatient Centers and randomly selected samples from 1995 till 2002 , to obtain 1125 samples from 180,000 samples of chr. disease, finally only 856 valid questionnaires were obtained for service satisfaction analysis in the 14 factors. Those samples was divided in to two groups; group 1 was continuance of selected Outpatient Centers for Medical care(428 samples)from march 1995 till 2002,and another group( group 0) was discontinuance of selected Outpatient Centers for Medical care(428 samples)since march 1997 , meanwhile frequency, description correlation factors analysis, chi-square, t-test and logistic regression analysis including effect of moderating variables were used to analyze the data of 856 valid samples.
The results indicate that (1) the service structures of medical care including outpatients delivery process. hi-tech equipment modern (equipment / technology),convenient location and parking & transportation problem (2) the service results of medical care including service attitude of physician, service attitude of nurses, environment, physician’s medical expertise and ethics, reputation Outpatient Centers, Image of Outpatient Centers and stable or good results after treatment were the top eleven important factors of two dimensions for those affected patients when they were choosing Outpatient Centers.
The logistic regression equation for probability of continuance of selected Outpatient Centers for medical care could be written as
Prob(event)=
.where
Z=-8.29+0.28(patient satisfaction of service structure of medical care)-0.33(patient satisfaction of service process of medical care)+0.29(patient satisfaction of service results of medical care).
Finally, the important finding in study including the probability of continuance of selected Outpatient Centers for medical care showed significant difference under the predisposing factors of the service structure and results of medical care but no significant difference under the predisposing factor of the process of medical care. Meanwhile, the moderating variables of family income and period of OPD showed significant interaction effect to the dimension of service structure of medical care.
Therefore, findings form the present study could provide information for the manager of Outpatient Centers to understand potential consumers and develope effective methods especially the dimensions of service structure and process of medical care of attracting clients under the consumers’ needs.
Key words ：logistic regression analysis，factor analysis ，moderating variables
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