医疗服务质量满意度CSI评价模型的实证研究--基于上海嘉

摘要I二О一二年十二月二0一二年十二月医疗服务质量满意度CSI评价模型的实证研究--基于上海嘉定区3家医院的数据摘要II摘要顾客满意是评价医疗服务的指标，也是衡量一个医疗单位、一个地区甚至是一个国家医疗体系运作情况的重要内容。本文针对医疗服务、顾客满意、服务质量等概念进行文献综述，以“美国顾客满意度指数模型（ACSI）”为研究模型的依据，以上海市嘉定区三所医院门诊患者作为研究对象，进行满意度的调查与研究。本文共分七章。第一章介绍了医疗服务过程中，患者满意度调查的研究背景与动机、研究目的与意义以及论文的章节结构。第二章为基本概念和基本理论的介绍。概念包括顾客满意、患者满意度、服务质量、服务流程等，理论包括公共产品、公共服务、新公共管理及满意度因果关系模型。第三、四章主要介绍了以“ACSI”为依据的患者满意度测量方法的设计。包括患者满意度测量指标的选择，患者满意度调查问卷的设计、调查方法、统计方法设计以及问卷信度和效度的测定。第五章以上海市嘉定区三所医院的门诊患者为研究对象，采用偶遇的方法，共获得有效调查问卷314份。对调查结果进行描述性统计分析和结构方程模型检验。第六章为针对模型结果的分析。第七章为结论与建议。结论：（1）患者满意度是评价医疗服务质量的常用指标之一；（2）随着医改“小病进社区”的政府导向，患者的就诊已经开始向社区卫生服务中心分流，患者更希望接受中西医结合的综合治疗；（3）自由选择医疗带来的医疗资源浪费和加重医疗拥挤的现象，值得重视；（4）简化服务手续和缩短患者在就诊中的等候时间，成为医院需要改进的问题之一；（5）医疗卫生收费增长过快引发“看病贵”，成为继等候时间过长的另一个主要矛盾，故降低医疗费用成为患者希望改进的问题；（6）强化服务意识，尤其应重视对患者投诉的管理和改进。关键词：满意度，卫生服务，测量工具AbstractIIIABSTRACTCustomers’satisfactionisanindexofevaluatingmedicaltreatmentservicesandisalsoakeyelementofjudgingtheoperationofamedicaltreatmentsysteminasinglemedicalinstitution,orinadistrictoreveninacountry.Thisthesisfocusesondocumentarydescriptionsofsuchtermsasmedicaltreatmentservices,customers’satisfaction,servicequality,etc.BasedonAmericanCustomers’SatisfactionIndex(ACSI),thethesisauthortakestheoutpatientsofthreehospitalsinShanghaiJia’dingDistrictassubjectsandconductsaseriesofinvestigationsandanalysisontheirsatisfaction.Thisthesisisdividedintosevenchapters.Includedinthefirstchapterarerelativebackground,researchmotivationandsignificanceoftheresearchonpatients’satisfactionandthethesisstructureaswell.Inthesecondchapter,somebasicconceptsandtheoriesareintroduced.Thebasicconceptsaremainlyaboutcustomers’satisfaction,patients’satisfaction,servicequalityandserviceprocedures.Thebasictheoriesarerelatedtopublicproducts,publicservices,newpublicmanagementandsatisfactionmodels.Thethirdandfourthchaptermainlyintroducesthedesignofevaluatingmethodsforpatients’satisfactionbymeansofACSI,includingchoiceofevaluatingindexes,thequestionnairedesignforpatientsatisfactioninvestigations,themethodsofinvestigations,thestatisticalinferenceandthereliabilityandvalidityofthequestionnaire.Inthefifthchapter,takingoutpatientsofthreehospitalsinShanghaiJia’dingDistrictastheresearchsubjects,theauthorgained314questionnairesatrandom,diddescriptiveanalysisoninvestigationresultsandexaminedthestructureequationmodels.Inthelasttwochapter,someconclusionsandsuggestionscanbefound,whicharelistedasfollows:1)Thecustomers’satisfactionisoneofcommonlyadaptedindexesforevaluatingmedicaltreatmentservices.2)Becauseofthemedicalreformnamed“treatingminorillnessesincommunityclinics”,whichisguidedbyChinesegovernment,manypeoplestarttoseekmedicaladviceortoseedoctorsincommunityhealthservicecenters.AndpatientsexpecttoreceiveacomprehensivemedicaltreatmentcombinedwesternmedicinewithChinesetraditionalmedicine.3)Shouldpayattentionto:thefreedomtochoosemedicalwasteofmedicalresourcesandtheaggravatecongestionphenomenon.AbstractIV4)Oneoftheurgentproblemstobesolvedinhospitalsistosimplifymedicalserviceproceduressoastoshortenthewaitingtimeformedicaltreatments.5)Nexttotheproblemofwaitinglongforseekingmedicaladviceisthatchargesformedicaltreatmentsincreasesofastthatmoreandmorepeoplefindithardtoaffordtheirmedicalexpenses.Sotheystronglyhopethatthepresentmedicalchargesshouldbeloweredasmuchaspossible.6)Allthemedicalworkersshouldenhancetheirserviceconsciousnessandparticularlypayattentiontocomplaintsfromallkindsofpatients.KeyWords:customers’satisfaction，sanitationservices，evaluatingmethods/tools目录V目录第1章导论.......................................................11.1选题背景及研究的目的和意义..................................11.2文献综述....................................................21.2.1国外研究概况..................................................21.2.2国内研究综述..................................................81.3研究内容和论文结构安排.....................................111.4研究思路与研究方法.........................................12第2章基本概念及相关理论........................................142.1基本概念...................................................142.1.1顾客满意度....................................................142.1.2公共部门的受众满意度..........................................172.1.3患者满意度...................................................182.1.4医疗服务质量.................................................182.1.5服务流程.....................................................182.2患者满意度测评的理论基础...................................192.2.1公共产品理论.................................................192.2.2公共服务理论.................................................202.2.3新公共管理理论...............................................202.2.4满意度因果关系模型理论........................................21第3章上海市嘉定区门诊满意度测评指标体系的建立..................233.1结构模型的主要因素.........................................233.1.1预期质量.....................................................233.1.2感知质量.....................................................233.1.3感知价值.....................................................243.1.4满意度指标...................................................243.2理论模型的建立.............................................25目录VI3.2.1模型假设...............