J Healthc Qual. 2024;46(3):150-159. doi: 10.1097/JHQ.0000000000000420. Epub 2024 Jan 12.
The implementation of the National Health Insurance has transformed the medical care landscape in Taiwan, rendering perceived medical service quality (PMSQ) and patient satisfaction significant focal points in medical care management. Past studies mostly focused on the technical aspects of medical care services, while overlooking the patients' perception of services and the delivery process of PMSQ in the medical care experience. This study integrated the theoretical framework of the Donabedian SPO model and the SERVQUAL questionnaire. The survey was conducted among the outpatients of three types of medical institutions in northern Taiwan: academic medical centers, metropolitan hospitals, and local community hospitals. A total of 400 questionnaires were collected, and 315 valid questionnaires remained after eliminating the incomplete ones. This study established a PMSQ delivery model to explore patients' perceptions of medical service quality. It was found that the variable, Assurance, could deliver the PMSQ and enhance the Medical outcome (MO), while improving the variable, Tangible, in medical institutions could not significantly enhance the MO. These findings emphasize the importance of healthcare institutions prioritizing the professional background, demeanor of their healthcare staff, treatment methods, and processes over tangible elements.
全民健康保险的实施改变了台湾的医疗保健格局,使感知医疗服务质量(PMSQ)和患者满意度成为医疗保健管理的重要焦点。过去的研究大多集中在医疗服务的技术方面,而忽略了患者对服务的感知以及医疗体验中 PMSQ 的交付过程。本研究整合了 Donabedian SPO 模型和 SERVQUAL 问卷的理论框架。该调查在台湾北部的三种类型的医疗机构的门诊患者中进行:学术医疗中心、大都市医院和当地社区医院。共收集了 400 份问卷,剔除不完整问卷后,仍有 315 份有效问卷。本研究建立了一个 PMSQ 交付模型,以探讨患者对医疗服务质量的感知。结果发现,保证变量可以传递 PMSQ 并提高医疗效果(MO),而提高医疗机构中的有形变量并不能显著提高 MO。这些发现强调了医疗机构优先考虑医疗人员的专业背景、风度、治疗方法和流程而不是有形元素的重要性。