| Summary: | 碩士 === 國立陽明大學 === 醫務管理研究所 === 92 === Abstract
National Health Insurance for Taiwan started in 1995. To provide accessibility and more service for patients, hospitals had to compete with each other. After the Global Budget in July 2002, this competition continued and even increased. All the hospitals looked for ways to reduce costs and maintain the medical service. However, loyalty to hospital contributes 20 % of all costs for a new patient. How to assess this patient loyalty and its influencing factors is an important issue for most hospitals at present.
This study used a local hospital in the Yangmei area as an example to explore the types of patient loyalty to hospital: the sensation to healthcare service on patient loyalty, perceptions of sacrifice, and patients characteristics. Telephone interviews involving a structured questionnaire were carried out with 400 outpatients over 18 years of age, living in Yangmei area. Those questioned had not been admission within the past 6 months. The sampling was based on age groups. Effective sample size was 382, 95.5 % of all.
The result showed premium loyalty 58.1 %, latent loyalty 17.1 % and inertia or no loyalty 24.8 %. Patients were concerned with ‘physician’s tender care for patients’ and ‘convenience of registration procedure’. ‘Waiting time at clinic’ is less important. The most important influence of the medical service on patient loyalty is ‘a kind physician with good experience’. The least important influence is ‘convenience of registration procedure’. The satisfaction for perception of sacrifice is between ‘acceptable’ and ‘satisfied’, and the importance, between ‘nothing important’ and ‘important’.
Personal characteristics, e.g. age, sex, education, chronic disease, birth experience have different impacts on the perception of healthcare service and sacrifice. All the components of personal characteristics have significant effect on patient loyalty, except for education and sex. The perception of medical service and sacrifice is well co-related with patient loyalty attitude and behavior. The results of stepwise multiple linear regression indicates that factors of service outcome , physician care, out-of-pocket costs, chronic disease, birth experience and external issues predicted on loyalty attitude(Adj R2＝0.531) . Factors of physician care, chronic disease, birth experience and service outcome predicted on loyalty behavior( Adj R2＝0.297)。
Hospitals should assess the factors influencing patient loyalty, realize that a gap exists between patients perceived healthcare quality and expectation and types of patient loyalty to make a good decision on Global Budget.
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