| 摘要: | 背景及目的：遠距健康照護服務已成為未來醫療照護服務創新的重點發展方向，然而目前對於如何提升其服務內涵與其服務品質仍缺乏研究。本研究旨在探討遠距健康照護服務品質的內涵與其相關影響因素。研究方法：本研究採用橫斷式問卷調查方式，應用服務品質缺口模式進行重要性-績效分析。研究對象為台灣南部某醫學中心接受遠距健康照護服務的慢性疾病被服務人，調查時間為2014年11月至2015年02月，有效樣本共150位。統計分析以SPSS 19統計套裝軟體進行描述性統計、獨立樣本T檢定、ANOVA、迴歸分析等。研究結果：在遠距健康照護服務品質「重視度」的部分，「保證性」最受到重視（4.933），最低則為「有形性」（4.320）。影響因素的部分，居住地以非高雄市之「有形性」（β=-0.18，p=0.0484）、「可靠性」（β=-0.21，p=0.0190）、「反應性」（β=-0.27，p=0.0017）、「保證性」（β=-0.22，p=0.0110）、「關懷性」（β=-0.25，p=0.0054）顯著高於高雄市被服務人。家庭平均月收入2-4萬之「有形性」（β=-0.27，p=0.0466）、2萬以下「可靠性」（β=-0.33，p=0.0138）、2萬以下「反應性」（β=-0.48，p=0.0002）、2-4萬之「反應性」（β=-0.25，p=0.0400）、2萬以下「保證性」（β=-0.43，p=0.0011）皆顯著高於平均月收入4-6萬被服務人。教育程度之「有形性」以國中（β=0.24，p=0.0339）、高中職（β=-0.23，p=0.0350）較專科以上顯著。職業則以有工作之「反應性」（β=-0.27，p=0.0038）較無工作者顯著。在遠距健康照護服務品質「滿意度」的影響，以「保證性」最感到滿意（4.984），最低則為「反應性」（4.693）。影響因素的部分，以年齡70歲以上之「有形性」（β=0.25，p=0.0140）滿意度顯著高於70歲以下。居住地以非高雄市之「反應性」（β=-0.27，p=0.0017）較高雄市顯著、職業則以有工作之「反應性」較無工作者顯著。家庭平均月收入以2萬以下「反應性」（β=-0.48，p=0.0002）、2-4萬之「反應性」（β=-0.25，p=0.0500）較4-6萬者顯著。每月服務費以850元/月之「可靠性」（β=-0.27，p=0.0489）較每月服務費1600元/月顯著。在重要性-績效分析的部分，需繼續維持的面向為「保證性」；需加強服務的面向有「可靠性」與「反應性」；過度服務的面向則為「有形性」；低優先處理為「關懷性」。結論與建議：使用民眾對遠距照護服務品質呈現顯著差異，建議後續應定期進行服務品質的評量、分析、檢討及策略方案的擬定，以俾使呈現最優質服務品質予以使用者。
Background and purpose: The pursuing of developing telehealthcare service has become one of the mainstreams in medical care innovation. However, it still lacks of the engagement of its service quality improvement. This study aims to explore the telehealthcare service quality and its related factors.Methods: This study used a cross-sectional survey based on the theory of importance-performance analysis and the PZB model. Participants were recruited with the experiencing telehealthcare services from a southern medical center in Taiwan. With the purposed sampling procedure, 150 participants were validated into this research from November 2014 to February 2015. Research analysis was used by SPSS 19 to conduct the descriptive statistics, independent t-test, ANOVA, and multiple linear regression analysis.Results: In the importance analysis for the telehealthcare quality, the dimentsion of "to ensure" got the most weighted (mean= 4.933), with the least weighted of "tangibility" (mean= 4.320). In the multiple linear regression analysis of factors affecting healthcare service quality, the residence area marked “non-Kaohsiung city” was significantly higher than “Kaohsiung city ” on all dimensions of "tangibility" (β= -0.18, p= 0.0484), "reliability" (β= -0.21, p= 0.0190), "reactive" (β= -0.27, p= 0.0017), "guarantee" (β= -0.22, p= 0.0110), and "concern" (β= -0.25, p= 0.0054). Monthly household income under 20K showed a relative higher level of service quality on the dimensions of "tangibility" (β= -0.27, p= 0.0466), "reliability" (β= -0.33, p= 0.0138), "reactive" (β= -0.48, p= 0.0002), "reactive" (β= -0.25, p= 0.0400), "guarantee" (β= -0.43, p= 0.0011). lower education level shows a relative higher service quality on the dimension of "tangibility" (β= 0.24, p= 0.0339). Those are employed status showed a higher level of service quality on the dimension of "reactive" (β= -0.27, p= 0.0038).In the section of analyzing satisfaction, the dimension of “guarantee” got the most weighted (mean= 4.984), with the least weighted of "reactive" (mean= 4.693). In the multiple linear regression analysis of factors affecting telehealthcare service quality, aged above 70 years old showed a relative high on "tangibility" (β= 0.25, p= 0.0140) than under 70 years old. The residence area marked “non-Kaohsiung city” was significantly higher than “Kaohsiung city” on the dimensions of "reactive" (β =-0.27, p= 0.0017). Those are employed status showed a relative higher level of service quality on the dimension of "reactive". Monthly household income under 20K showed a relative higher level of service quality than above 40K on the dimensions of "reactive" (β= -0.48, p= 0.0002) and "reactive" (β= -0.25, p= 0.0500). In the section analyzing the importance-performance analysis, the dimension of "assurance" is judged as keeping up it service procedure; with respect to "reliability" and "reactive" were judged as forced to improve; and the judged as over delivered were "tangible" and "care".Conclusions: Based on the study, we concluded the factors affecting telehealthcare service quality were diversified by its dimensions. Further research was suggested practically regular monitor the measurement of service quality, and including it analysis, assessment and policy making. |
