以多群組分析探討中醫診所服務品質與忠誠度之因果模式

Causal Model of Service Quality and Customer Loyalty for a Chinese Medicine Clinic by Multiple-Group Analysis

張永佳(Yung-Chia Chang)；張燦明(Tsan-Ming Chang)

多群組分析 ； 服務品質 ； 期望服務 ； 知覺服務 ； multiple-group analysis ； service quality ； expected service ； perceived service

品質學報

17卷3期（2010 / 06 / 30）

179 - 206

繁體中文

本文以中醫診所個案之求診者爲研究對象，藉由Parasuraman、Zeithaml與Berry三位學者所發展衡量服務品質模式（簡稱爲PZB模式）的五大構面即有形性、可靠性、回應性、保證性、關懷性，透過結構方程模式(Structural Equation Modeling, SEM)，以多群組分析(Multiple-Group Analysis)與事後多重模式檢定(Post Multiple-Model Test)，探討在服務品質五構面的模式下，民眾於看診前「期望服務」及看診後的「知覺服務」分別對顧客忠誠度之影響。研究結果發現，期望服務五構面與知覺服務的可靠性、保證性、關懷性三構面皆會影響顧客忠誠度，但是已婚和未婚兩群組於期望服務關懷性與忠誠度之間，卻有不一致的因果關係。

This study uses a Chinese medical clinic as an example to explore the relationships between service quality and customer loyalty. Through the use of structural equation modeling (SEM), multiple-group analysis and post model test, this study analyzes how customers' ”expected service” and ”perceived service” affect their loyalty under the five aspects of service quality-tangibles, reliability, responsiveness, assurance and empathy developed by Parasuraman, Zeithaml and Berry on service quality (also known as the PZB model). This study found that the five aspects of expected service and the three aspects (reliability, assurance and empathy) of perceived service have significant effects to customer loyalty. Moreover, from the results of multiple-group analysis, the marriage status (married and unmarried) has different cause-effect relationships in empathy aspect.

1. 池文海、楊宗儒、賀春生(2007)。新聞網站服務品質、顧客滿意度與忠誠度關係之研究。品質學報，14(3)，285-299。
   連結：
2. 張景盛、翁慧卿、徐村和(2007)。從服務接觸觀點探討不同科別醫療服務品質之差異─以一般科與婦產科門診為例。品質學報，14(3)，301-314。
   連結：
3. Babakus, E.,Boller, G. W.(1992).An empirical assessment of the SERVQUAL scale.Journal of Business Research,24(3),253-268.
4. Bitner, M. J.,Booms, B. H.,Tetreault, M. S.(1990).The service encounter: diagnosing favorable and unfavorable incidents.Journal of Marketing,54(1),71-84.
5. Bowers, M. R.,Swan, J. E.,Koehler, W. F.(1994).What attributes determine quality and satisfaction with health care delivery?.Health Care Management Review,19(4),49-55.
6. Brown, I.(2006).Nurses' attitudes towards adult patients who are obese: literature review.Journal of Advanced Nursing,53(2),221-232.
7. Carman, J. M.(1990).Consumer perceptions of service quality: an assessment of the SERVQUAL dimensions.Journal of Retailing,66(1),33-55.
8. Chang, C. L.(2006).Application of quality function deployment launches to enhancing nursing home service quality.Total Quality Management and Business Excellence,17(3),287-302.
9. Churchill, G. A. ,Jr.(1979).A paradigm for developing better measure of marketing constructs.Journal of Marketing Research,16(1),64-73.
10. Churchill, G. A. ,Jr.,Suprenant, C.(1982).An investigation into the determinants of customer satisfaction.Journal of Marketing Research,19(4),491-504.
11. Cronin, J. J.,Taylor, S. A.(1992).Measuring service quality: a reexamination and extension.Journal of Marketing,56(3),55-68.
12. Crosby, L.,LeMay, S. A.(1998).Empirical determination of shipper requirements for motor carrier services: SERVQUAL, direct questioning, and policy capturing methods.Journal of Business Logistics,19(1),139-153.
13. Darby, M. R.,Karni, E.(1973).Free competition and the optimal amount of fraud.Journal of Law and Economics,16(1),67-86.
14. Davido, W. H.,Uttal, B.(1989).Total Customer Service: The Ultimate Weapon.New York:Harper Collins Publishers Inc..
15. Deming, W. E.(1982).Quality Productivity and Competitive Position.Cambridge, MA:MIT Press.
16. Donabedian, A.(1980).Explorations in quality assessment and monitoring: the definition of quality and approaches to its assessment.Ann Arbor, Michigan:Health Administration Press.
17. Finn, D. W.,Lamb, C. W.(1991).An evaluation of the SERVQUAL scales in a retailing setting.Advances in Consumer Research,18(4),483-490.
18. Fisher, C. M.,Anderson, C. J.(1990).Hospital advertising: does it influence consumers.Journal of Health Care Marketing,10(4),40-46.
19. Goetsch, D. L.,Davis, S.(1994).Introduction to Total Quality: Quality, Productivity, Competitiveness.New York:Macmillan.
20. Griffin, J.(1996).The Internet's expanding role in building customer loyalty.Direct Marketing,59(7),50-55.
21. Gronholdt, L.,Martensen, A.,Kristensen, K.(2000).The relationship between customer satisfaction and loyalty: cross-industry differences.Total Quality Management,11(4-6),509-514.
22. Gronroos, C.(2000).Service Management and Marketing: a Customer Relationship Management Approach.New York:Wiley.
23. Gronroos, C.(1984).A service quality model and its marketing implications.European Journal of Marketing,18(4),36-44.
24. Hair, J. F.,Aderson, R. E.,Tatham, R. L.,Black, W. C.(2006).Multivariate Data Analysis.Upper Saddle River, New Jerssey:Pearson Education Inc..
25. Jacoby, J.,Kyner, D. B.(1973).Brand loyalty vs. repeat purchasing behavior.Journal of Marketing Research,10(1),1-9.
26. Juran, J. M.(1986).A universal approach to managing for quality.Quality Progress,19,10-24.
27. Kristensen, K.,Martensen, A.,Gronoldt, L.(1999).Measuring the impact of buying behavior on customer satisfaction.Total Quality Management,10,602-614.
28. Lovelock, C. H.,Wirtz, J.(2007).Service Marketing.Upper Saddle River, New Jersey:Prentice Hall.
29. Mazis, M. B.,Ahtola, O. T.,Klippel, R. E.(1975).A comparison of four multi-attribute models in the prediction of consumer attitudes.Journal of Consumer Research,2,38-52.
30. Neal, J. D.,Sirgy, M. J.,Uysal, M.(1999).The role of satisfaction with leisure travel/tourism services and experience in satisfaction with leisure life and overall life.Journal of Business Research,44(3),153-161.
31. Nelson, P.(1974).Advertising as information.Journal of Political Economy,82(4),729-754.
32. O''Connor, S. J.,Bowers, M. R.(1990).An integrative overview of the quality dimension: marketing implications for the consumer-oriented health care organization.Medical Care Review,47(2),193-219.
33. Oliver, R. L.(1999).Whence consumer loyalty?.Journal of Marketing,63(1),33-44.
34. Parasuraman, A.,Zeithaml, V. A.,Berry, L. L.(1988).SERVQUAL: A multi-item scale for measuring consumer perception of service quality.Journal of Retailing,65(1),41-50.
35. Parasuraman, A.,Zeithaml, V. A.,Berry, L. L.(1985).A conceptual model of service quality and its implications for future research.Journal of Marketing,49(4),41-50.
36. Reeves, C. A.,Bednar, D. A.(1994).Defining quality: alternatives and implications.Academy of Management Review,19(3),419-445.
37. Sasser, W. E.,Olsen, R. P.,Wyckoff, D. D.(1978).Management of Service Operations: Text and Cases.Boston:Alley and Bacon Inc..
38. Sovd, T.,Mmari, K.,Lipovsek, V.,Manaseki-Holland, S.(2006).Acceptability as a key determinant of client satisfaction: lessons from an evaluation of adolescent friendly health services in Mongolia.Journal of Adolescent Health,38(5),519-526.
39. Stewart, H.,Hope, C.,Muhlemann, A.(1998).Professional service quality.Journal of Retailing and Consumer services,5(4),209-222.
40. Stum D. L.,Thiry, A.(1991).Building customer loyalty.Training and Development Journal,45(4),34-36.
41. Triplet, J. L.,Yau, O. H. M.,Neal, C.(1994).Assessing the reliability and validity of SERVQUAL in a longitudinal study: the experience of an Australian organization.Asia Pacific Journal of Marketing and Logistics,6(1-2),41-62.
42. Williams, S. A.(1998).Quality and care: patients' perception.Journal of Nursing Care Quality,12(6),18-25.
43. Zeithaml, V. A.,Berry, L. L.,Parasuraman, A.(1988).Communication and control processes in the delivery of service quality.Journal of Marketing,52,35-48.
44. Zeithaml, V. A.,Berry, L. L.,Parasuraman, A.(1996).The behavioral consequences of service quality.Journal of Marketing,60(2),31-46.
45. Zeithaml, V. A.,Berry, L. L.,Parasuraman, A.(1993).The nature and determinants of customer expectations of service.Academy of Marketing Science Journal,21(1),1-12.
46. 王廷輔(1990)。臺中地區居民中西醫療行為取向之研究。中華民國公共衛生學會雜誌，17(1)，21-33。
47. 王保進(1996)。統計套裝程式SPSS與行為科學研究。台北:松岡電腦圖書資料股份有限公司。
48. 李金鳳(1990)。碩士論文(碩士論文)。陽明醫學院公共衛生研究所。
49. 林美珠(2001)。碩士論文(碩士論文)。國立陽明大學衛生福利研究所。
50. 林清山(1984)。「線性結構關係」（LISREL）電腦程式的理論與應用。測驗年刊，31，149-164。
51. 邱清華(1990)。行政院經濟建設委員會委託計畫成果報告行政院經濟建設委員會委託計畫成果報告,行政院經濟建設委員會。
52. 徐綺縵(2006)。碩士論文(碩士論文)。元智大學管理研究所。
53. 張秀婉(2004)。碩士論文(碩士論文)。國立成功大學。
54. 張慶良(2001)。碩士論文(碩士論文)。長榮管理學院經營管理研究所。
55. 莊演文(2003)。碩士論文(碩士論文)。南華大學管理研究所。
56. 陳倩妮(1998)。碩士論文(碩士論文)。元智大學管理研究所。
57. 陳順宇(2007)。結構方程模式。台北:心理出版社。
58. 蔡相君(2005)。碩士論文(碩士論文)。大葉大學國際企業管理學系。
59. 戴久永(1987)。品質管理。台北:三民書局。
60. 顏仲毅(2007)。碩士論文(碩士論文)。臺灣大學醫療機構管理研究所。

1. 陳順興、吳逸萍(2012)。全面品質管理對行銷管理、顧客滿意度與顧客忠誠度影響之研究─以國內證券業為例。品質學報，19(5)，491-522。
2. 郭幸萍、吳綱立(2012)。民宿業之服務屬性對顧客行為意圖的影響─以關係品質為中介變數。戶外遊憩研究，25(4)，51-78。
3. 李蕙貞(2011)。二維模式在自行車賽服務品質之應用。大專體育學刊，13(4)，349-358。
4. 楊雅琪(2018)。應用重要度－滿意度分析探討室外網球場服務品質。Journal Of Data Analysis，13(4)，29-42。
5. 張燦明,李玫憲,王芳醴(2015)。大學生性別角色、金錢態度與理財行為之研究：以修平科大學生為例。修平學報，31，135-156。