A Study of the Family Physicians-Based Comprehensive Care Plan from the Perspective of the Gap Theory

• Main Authors: May-Fung Yu, 游美芳
• Other Authors: Ming-Ta Tsai
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/60505047678929666591

碩士 === 佛光大學 === 管理學研究所 === 95 === Nowadays the Taiwan population is facing issue of aging and the increase of chronic disease that comes along. The Family Physicians-Based Comprehensive Care Plan (or the Family Physicians Program) is a key point of the reform of the post-SARS Taiwan medical system. On the other hand, it is to let the people having correct healthcare knowledge and to form the correct attitude in seeking medical advice, preventing repeated examination and to reduce the wasting of medical resource. Therefore, how the Family Physicians Program can be continuously promoted and developed is the main motivation of this research. This research is to study the two major groups of people, the general public and the doctors at the primary level, by using the service quality gap model to probe into the Family Physician Program service disparity, hope that one can improve the service quality of the program. This research has the household members and the primary level family physicians, who are participating in the program as its research object, and to study the differences of the satisfactory level of the service quality on the Family Physicians Program by using the P.Z.B service quality model. The research adopts the questionnaire and in-depth interview methods, and the questionnaire is using the SERVQUAL scale as the main framework and measuring tool. Through the difference between expectation and perception of the household members on the Family Physician Program, the research probes into the items where improvement on service quality is needed. The research also analyzes the demographic parameter of the household members and the degree of their satisfaction on the plan. For the part of the doctor at the primary level, the research adopts the in-depth interview method, to discuss the gap of the service execution influencing by the systemic aspects, and the gap between the service quality standard set by the Health Insurance on the Family Physician Program and the expectation of the primary level doctors on the family physicians system. From the studies, this research has discovered that, between the household members’ expectation on the service level of the Family Physicians Program and the level of service they have perceived, the biggest gap happen on the three items of appropriate referral, fast alleviation of condition and the ease to discuss by phone. Between the service quality standard stipulated by the Bureau of Health Insurance on Family Physician Program and the execution degree that the primary level doctors have perceived, it is the quantitative-based evaluation that all the doctors felt most unreasonable. Secondly, it is the follow-up of development of the condition, the course for certification and the credit for courses, information system, and the primary level doctor’s level of understanding regarding the programmatic content. In term of the gap between the household members’ expectation on the service level of the program and standard stipulates by the Bureau of Health Insurance, it is the Bureau of Health Insurance who did not investigate the household members’ expectation and actual feeling, and the upward communication and execution of the doctor at the primary level which has a great discrepancy.