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系統識別號 U0002-2706200521102300
中文論文名稱 顧客參與在醫療服務過程中所扮演之角色
英文論文名稱 The Role of Customer Involvement in Healthcare Service Process
校院名稱 淡江大學
系所名稱(中) 管理科學研究所企業經營碩士在職專班
系所名稱(英) Executive Master's Program of Business Administration in Management Sciences
學年度 93
學期 2
出版年 94
研究生中文姓名 李曉芬
研究生英文姓名 Hsiao-Fen Lee
學號 791590408
學位類別 碩士
語文別 中文
口試日期 2005-05-31
論文頁數 58頁
口試委員 指導教授-李培齊
委員-趙義隆
委員-吳淑華
中文關鍵字 顧客參與  醫療服務  顧客滿意度 
英文關鍵字 Customer Involvement  Healthcare service  Customer Satisfaction 
學科別分類 學科別社會科學管理學
中文摘要 在生命科學、醫藥和醫療保健等技術突破的幫助下,人類壽命的質與量均較前進步,這個世紀的人們將是共同見證「長壽」的第一批人類。全世界已開始邁入老年化社會結構,人類可以大幅的延長壽命,但在延長壽命的過程中,我們必須仰賴良好的醫療技術及服務來維持優質的生命品質,如此一來不僅對醫療服務的需求增加,同時對醫療服務品質的期望與要求也愈來愈高。台灣自1995年3月起全面實施全民健康保險,此舉大大地降低了民眾就醫的經濟障礙,使得社會大眾對於醫療服務品質的期望更為殷切,同時也加劇醫療市場的競爭。

而醫療服務業在服務設計與服務專業上有別於一般服務業,基本上製造業產品行銷有4P:即Product(產品)、Price(價格)、Promotion(推廣)以及通路(Place)﹔根據Booms及Bitner(1981)兩位作者的報告﹐認為有關服務業的服務模式(Service Model),除傳統製造業的4P外,還要加上3P,也就是:參與者(Participants):包括提供服務者及接受服務的人;有形物証(Physical evidence):不管就提供者或接受者角度,服務所提供的雖然不像產品那麼具體但是也是實質存在的;服務過程的組合(Process of service assembly)。服務業強調服務的過程,所以服務的模式除了有參與者和實質提供的服務性產品外,還要受「服務的過程」多所影響。

然而,一般的服務業接受服務者在程度上或多或少能參予或有能力提供意見,而醫療服務業則不一樣,提供服務的人比較獨裁(專業掛帥),要如何提供服務但憑自身專業,而接受服務的人能商榷的空間有限,所以基本上醫療業是一個專業法西斯(林永福,2002),不過因近年來醫學知識以及消費者主動性(active consumer)觀念(Brantes 2001)的普及,民眾參予醫療計劃訂定及實踐的比重亦愈來愈高。

儘管有愈來愈多的學者在開始探討服務業,但多專注於商品交易過程的服務品質,而在服務接受者和服務傳遞者互動程度較高之產業(譬如醫療業)則較少著墨。事實上,顧客在醫療服務的過程中,除了希望得到產品或服務本身所提供的部分,同時也希望充分享受一個有價值的經驗。但是國內對於醫療人員、病患之間溝通的實證研究則付之闕如,現有的文獻多集中在當家屬面臨重症危急病人時所產生的壓力和調適過程,以及如何滿足病患在認知、情感和社會等不同層次的需求,以改善病患家屬的焦慮和壓力(劉盈君等,1999;黃瑞美等,1997)。本研究之研究目的是促使醫療院所在面對激烈的變動環境下,以較適合的因應方式應對病患,對顧客建立起一對一的醫病互動關係,不但可以維持現有的顧客、贏得新的顧客,並能提昇顧客對於醫療院所的顧客滿意度,更期望因此而提高醫院的獲利貢獻程度。
英文摘要 Assist by technology breakthrough on Genetic Science, Medicine and Healthcare, human being has a great improvement on life itself and its quality and quantity.

Human race of this century will be the first group of people to jointly witness the meaning of the word “Longevity”. When society construction is moving forward to an elderly’s era, human can rely on good medication technology and medical services to maintain his life, gracefully with fine quality of life. Which eventually increase our reliance on Medical services, as well as the expectation and inquiry of service standard. .

Since March 1995, Taiwan government commenced to implement health care insurance plan for all citizens, it actually decreased people’s medical inquiry’s economic barrier, also triggered the general public to have a better expected standard on medial service’s standard and competition among all in Medical industry.

Since Medication Service Industry(MSI) differs to traditional service industry on service designation and service professionalism, traditional production industry’s marketing bible -- 4P, Product, Price, Promotion and Place are not enough for MSI. MSI marketing strategy also requires 3 more Ps (Booms & Bitner 1981), they are Participants, Physical evidence and Process of service assembly. Agree by service providers or by service receivers , service industry will emphasizes on service’s process. Not just on tangible issues.

In traditional service industry, consumer and patient are more or less able to support and to get useful information base on his own experience. But, this experience does not apply to Medication service industry. Because medication service providers generally are more professionalism oriented, they decide the service quality and quantity base on their professional training, therefore, consumers, or, patients has a very limit space to negotiate service issues with providers. Basically, medication service industry may be called a Professional Fascist. However, due to popularity of active consumer concept and easy to have medication knowledge. Consumers or patients are more possible to participate on establishing and implementation of medical treatment.

Although there are more and more scholars commence to study on service industry, mostly, they concentrate on service quality on procurement process, and less focus on industries require service provider and consumer to have more frequent interactive in between, i.e. Medical treatment industry. As matter of fact, whilst patients receive product or service, at the same time, they also wish to receive a more valuable experience. However, there are very few studies of communication between medical service providers and receivers. What we may find are more focusing on stress and adjust process when facing family member meets severe and critical health situation, and how to satisfy patient’s acknowledgement, emotional and social needs, as well as how to help patient’s family to solve anxiety and stress problems. The purpose of this research is pushing medical hospitals or venues to build up a one on one relationship with its patients, and utilizing a more suitable method to treat patients, particularly in the dramatic changing environment as now is. Not only this movement may maintain their exists customers, also may earn new customers. Meantime, can give hospital’s profit contribution, together with reaching a higher customer satisfaction.
論文目次 第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 3
第二章 文獻探討 5
第一節 醫療服務與顧客滿意度 5
第二節 顧客參與的定義 9
第三節 顧客參與對服務品質的影響 16
第四節 研究架構 19
第三章 研究設計與方法 20
第一節 研究方法之選擇 20
一、 質性研究: 20
二、 深度訪談法: 21
第二節 研究對象 23
第四章 實證結果分析 25
第一節 醫病溝通的現象 25
一、看診的時間有限 25
二、專業知識的不對稱 27
三、顧客的情緒問題 29
四、觀念及價值觀的不同 30
第二節 顧客參與的情境分析 32
一、顧客個性與背景對於參與的影響 32
二、不同疾病類型顧客參與的程度 32
三、第三者參與對醫療溝通的影響 34
第三節 顧客參與對醫療服務的影響 36
第四節 醫師對顧客參與的因應方式 40
第五章 結論與建議 43
第一節 研究結論 43
一、醫師與顧客間的溝通問題 43
二、第三者對醫療溝通的影響 44
三、顧客參與對醫療服務的影響 45
四、醫師對顧客參與的因應方式 46
第二節 研究建議 48
第三節 研究限制 50
參考文獻 51
一、中文部分: 51
二、英文部分: 52
附錄 訪談問題大綱 57

表目錄
表2-2-1顧客參與之相關性文獻整理 12
表2-2-2醫療行為中顧客參與程度 14
表3-2-1醫師受訪者的基本資料 23
表3-2-2病患受訪者的基本資料 24
表4-3-1病患參與對醫師的正面影響 36
表4-3-2病患參與對醫師的負面影響表 37
表5-1-1醫師與顧客間的溝通問題 43
表5-1-2高度顧客參與的因素: 44
表5-1-3第三者對醫療溝通的影響 44
表5-1-4顧客參與對醫療服務的正面影響 45
表5-1-5顧客參與對醫療服務的負面影響 46
表5-1-6顧客參與的處理方式 46

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