應用認知價值選擇模式分析病患至基層診所就診意願相關因素

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Title:	應用認知價值選擇模式分析病患至基層診所就診意願相關因素 Application of the Perceived Value Choice Model to Analyze the Factors Associated with Patients' Willingness to Visit Primary Care Clinics
Authors:	蔡文正龔佩珍翁瑞宏
Contributors:	醫療資訊管理研究所
Keywords:	就醫重要性因素就醫選擇價值認知選擇模式就診意願 important factors for medical care medical care choices perceived value choice model primary care clinics willingness to visit
Date:	2007-10
Issue Date:	2010-01-15 11:44:02 (UTC+8)
Abstract:	目的　本研究以認知價值選擇模式探討民衆對基層診所各項就醫因素之認知，並分析其就醫意願與相關因素。同時，探討認知價值選擇模式在民衆選擇基層診所就醫決策過程中之適用性，以提供後續研究者參考。方法　本研究以問卷調查方式，在各層級醫療院所門診病患採隨機系統抽樣，有效樣本1148份，並應用描述性統計分析、序位羅吉斯迴歸分析探討民衆選擇診所就醫之主要考量因素、對基層診所之就診意願與其相關因素。結果　民衆至診所就醫意願方面，36.1%民衆有高度意願，但是15.1%民衆低度意願。不論生小病或有慢性病的民衆選擇以診所爲就醫場所的主要考量以犧牲屬性因素「等候時間」與「交通時間」爲優先。民衆至診所就醫時重要性因素評價方面，以「病情解說」、「環境衛生」與「醫術」等品質屬性因素最爲重要。對診所醫療服務滿意度評價方面，以「醫師看病態度」、「醫術」、「醫病關係」等三項品質屬性因素最高。經過序位羅吉斯迴歸分析後，在控制相關變項後，民衆對「醫術」的滿意度顯著影響民衆就診意願(p<0.05)。結論　當民衆生小病時民衆至基層診所就醫意願主要以犧牲屬性爲優先考量，但是至診所就醫時以品質屬性因素爲最重要。 Purpose. This study uses the perceived value choice model to analyze the factors associated with patients' willingness to visit primary care clinics. The study also evaluates the applicability of the perceived value choice model to analyze patients' decisions to choose primary care clinics. Methods. Structured questionnaires were used to systematically interview 1148 outpatients randomly selected from health service organizations. Basic information about patients' opinions and assessments of services received from clinics was analyzed by descriptive statistics. Factors associated with the willingness of patients to visit clinics were identified using the ordinal logistic regression method. Results. We found that 36.1% of patients were very willing to visit primary care clinics, but that 15.1% were unwilling. When patients had minor illnesses or chronic diseases, the primary reasons for choosing primary care clinics were "shorter waiting time" and "shorter transportation time" these factors belonged to sacrifice attributions. The perceived value model revealed that the three most important factors determining the quality of clinic care were the explanations given by physicians about the illnesses, cleanliness of the clinic and perceived knowledge and competence of the physician. The leading three factors with high patient satisfaction for clinic services were physician's manner and attitude, rapport between physicians and patients, and the physician's knowledge and competence. According to the results of the ordinal logistic regression model, after controlling for the related variables, only the patients' satisfaction with "physician's knowledge" and "competence" significantly affected patients' willingness to visit primary care clinics (p<0.05). Conclusion. The factors affecting the willingness of patients with minor illnesses to visit primary care clinics were sacrifice attributions. However, when patients visited the clinic, the most important service factors were quality attributions rather than sacrifice attributions.
Relation:	中台灣醫學科學雜誌 12(4)： p.220-229
Appears in Collections:	[Dept. of Hospital and Health (including master's program)] Periodical Articles

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