Quality Gap Analysis for Cardiac Catheterization Service

• Main Authors: Chuan-Uan Yeh, 葉娟娟
• Other Authors: 蔡文正
• Format: Others
• Language: zh-TW
• Published: 2006
• Online Access: http://ndltd.ncl.edu.tw/handle/75389582860548926767

碩士 === 中國醫藥大學 === 醫務管理學研究所碩士班 === 94 === Objective: Cardiovascular disease was the second cause of mortality in Taiwan. The incidence of the coronary arterial disease increased progressively year by year. Percutaneous transluminal coronary angioplasty/Stent is the standard procedure of treating the coronary disease. Our study made use of the service quality model (SERVQUAL model) to find the perceptive gap of the medical quality between the medical professionals and patients (gap 1) and the gap between the expectance of medical quality and satisfaction of the patients (gap 5). The gaps would be the reference of improving the quality of coronary catheterization service. Method: The samples included the physicians and nurses of the catheterization room and the patients receiving coronary catheterization of the hospitals in mid-south Taiwan. We collected data with questionnaire by interviewers. The valid questionnaire includes 75 medical professionals and 603 patients. The questionnaire was designed from PZB’s SERVQUAL questionnaire. We used the descriptive statistics, bivariate analysis, and multiple regression analysis to find the gap between the expectance of medical quality and satisfaction of the patients (gap 5) and to find the factors influencing the overall medical satisfaction. At last, we use the importance - performance analysis (IPA) to detect the service items needed to be concentrated for improvement. Result: At the gap of expectance of the medical quality between the medical professionals and patients, the dimension of “responsiveness” was ranked the first, then the “tangibles”, “assurance”, “empathy” and “reliability” as order. The 3 items causing the major gap were the appropriate medical consultation, convenience and the professional dress. The bivariate analysis revealed that the gap 1 of the physicians is larger than that of the nurses. At the gap 5, the ranks of 5 dimensions were “tangibles”, “responsiveness”, “empathy“, “reliability” and “assurance” as order. Multiple regression analysis revealed that the mean family income, physical discomfort, operative site and the hospital level had a different effect on gap 5. The influent factors of the patient’s satisfaction included the level of patient’s education, mean family income, severity of the pain and the dimension of “empathy”. IPA revealed “safe equipments”, “clean comfortable environment”, “professional knowledge” and “the first consideration of the patient’s advantage” fell in “concentrate here” respectively. Conclusion: The manager should understand the needs and the gaps of coronary catheterization service to increase the competitive ability. Especially, the fives items falling in the “concentrate here” revealed by IPA should be improved first to arrive the patient’s perceptive quality.