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1、（售后服务）医疗服务质量满意度CSI评价模型的实证研究基于上海嘉 二一二年十二月二0一二年十二月 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
2、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
3、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 ABSTRACT Customers satisfaction is an index of evaluating medical treatment services and is also a key element of judging the operation o
4、f a medical treatment system in a single medical institution, or in a district or even in a country. This thesis focuses on documentary descriptions of such terms as medical treatment services, customers satisfaction, service quality, etc. Based on American Customers Satisfaction Index (ACSI), the t
5、hesis author takes the outpatients of three hospitals in Shanghai Jiading District as subjects and conducts a series of investigations and analysis on their satisfaction. This thesis is divided into seven chapters. Included in the first chapter are relative background, research motivation and signif
6、icance of the research on patients satisfaction and the thesis structure as well. In the second chapter, some basic concepts and theories are introduced. The basic concepts are mainly about customers satisfaction, patients satisfaction, service quality and service procedures. The basic theories are
7、related to public products, public services, new public management and satisfaction models. The third and fourth chapter mainly introduces the design of evaluating methods for patients satisfaction by means of ACSI, including choice of evaluating indexes, the questionnaire design for patient satisfa
8、ction investigations, the methods of investigations, the statistical inference and the reliability and validity of the questionnaire. In the fifth chapter, taking outpatients of three hospitals in Shanghai Jiading District as the research subjects, the author gained 314 questionnaires at random, did
9、 descriptive analysis on investigation results and examined the structure equation models. In the last two chapter, some conclusions and suggestions can be found, which are listed as follows: 1) The customers satisfaction is one of commonly adapted indexes for evaluating medical treatment services.
10、2) Because of the medical reform named “treating minor illnesses in community clinics”, which is guided by Chinese government, many people start to seek medical advice or to see doctors in community health service centers. And patients expect to receive a comprehensive medical treatment combined wes
11、tern medicine with Chinese traditional medicine. 3) Should pay attention to: the freedom to choose medical waste of medical resources and the aggravate congestion phenomenon. 4) One of the urgent problems to be solved in hospitals is to simplify medical service procedures so as to shorten the waitin
12、g time for medical treatments. 5) Next to the problem of waiting long for seeking medical advice is that charges for medical treatments increase so fast that more and more people find it hard to afford their medical expenses. So they strongly hope that the present medical charges should be lowered a
13、s much as possible. 6) All the medical workers should enhance their service consciousness and particularly pay attention to complaints from all kinds of patients.Key Words: customers satisfaction，sanitation services，evaluating methods/tools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
14、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
15、型的建立253.2.1 模型假设253.2.2 理论模型25第4章调查问卷设计274.1问卷设计原则274.2 问卷设计内容274.3 数据收集274.4 统计方法设计284.5问卷前测284.5.1信度分析284.6.2效度分析29第5章上海市嘉定区三所医院门诊患者满意度数据分析315.1 嘉定区社会经济、医疗卫生情况简介315.2 调查问卷描述性统计分析315.2.1 人口学描述性统计325.2.2就医选择倾向性描述分析335.2.3 测量指标描述性分析345.3 因子分析365.3.1 预期质量因子分析365.3.2 感知质量因子分析375.3.3 感知价值因子分析395.3.4 满意度指标因子分析405.4方差分析415.4.1不同个体属性对相关因子的方差分析415.4.2年龄对相关因子的方差分析425.5 相关分析445.6 回归分析445.6.1预期质量和感知质量回归分析445.6.2 预期质量和感知价值回归分析455.6.3 感知质量和感知价值回归分析465.6.4 感知价值和满意度回归分析485.6.5感知
