| Summary: | 碩士 === 國立臺灣大學 === 高階公共管理組 === 97 === Dialysis therapy is important and necessary for uremia patients to prolong their lives. Because of the uniqueness of treatment and patient characteristics, hemodialysis patients have different perceptions and considerations on their medical care seeking behavior. The behavior includes the choice of medical institution; the special needs; expectations and satisfaction of dialysis treatment. Nevertheless, not only the competitions among dialysis facilities have become more intense after global budget system implemented, but also the reimbursements of health insurance have been cut down yearly. Therefore, all the dialysis facilities face the difficult challenge, i.e., how to prioritize the service quality expectations of their patients? Moreover, how to effectively allocate limited resources to meet the specific needs of patients?
The efficient management for corporate to take competitive advantages by applying strategy of differentiation was based on the association of corporate core complement and resource to the differentiation of customers’ actual need. Kano’s model had been applied in medical service industries to recognize the needs and expectations of patients. Hence, this study was using Kano’s model to identify the factors which affected the perceptions and considerations on medical seeking behavior of hemodialysis patients. Also the relationship between patient satisfaction and patient demographics, patient characteristics had been explored among various medical facilities. Furthermore, it was expected to establish a well-constructed evaluation instrument to appropriately evaluate the quality of medical service during dialysis therapy process through this study.
This was a cross-sectional study. 300 completed personal interview surveys from 320 hemodialysis patients in the Taipei metropolitan area were collected. These surveys were investigated with a structured, closed and self-designed questionnaire. Chi-square, analysis of variance, and post hoc comparisons were also employed.
The results revealed that 1) the quality properties of hemodialysis medical service and quality elements could be identified by using Kano’s model. 2) there were statistically significant differences among the hemodialysis patients at different levels of dialysis facilities on the assessment of the service quality elements. 3) in addition to the different levels of dialysis facilities, traveling time was also an important effective factor on the assessment of service quality elements in hemodialysis patients. 4) patients at different levels of dialysis facilities had significant differences on the satisfaction with the quality of dialysis service. And 5) Kano’s two-dimensional quality had influence on the satisfaction of dialysis patients.
Dividing the dialysis service items into quality elements in accordance with Kano’s model could provide more evident direction for the executives of dialysis facilities to improve patient satisfaction and to enhance dialysis service.
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