家庭牙醫門診病人就醫行為、醫療服務品質與忠誠度之關聯

Relationship among Dental Visit Behavior, Medical Service Quality and Patient Loyalty at the Family Dentistry Department

李貞儀(Chen-Yi Lee)；陳年香(Nien-Hsiang Chen)；彭紀棟(Chi-Tung Peng)；孫瑀勵(Yu-Li Sun)；黃妡渝(Hsin-Yu Huang)；葉竹菁(Chu-Ching Yeh)；吳如惠(Ju-Hui Wu)

醫療服務品質 ； 忠誠度 ； 牙科焦慮 ； SERVQUAL量表 ； Medical service quality ； Loyalty ； Dental anxiety ； SERVQUAL questionnaire

醫學與健康期刊

11卷2期（2022 / 07 / 01）

65 - 78

繁體中文

目的：探討南部某醫學中心家庭牙醫科病人的社會人口學變項與牙科就醫行為，對醫療服務品質和忠誠度的影響。方法：採結構式問卷以方便取樣執行，於2020年8月至2021年4月執行問卷施測，共回收有效問卷144份，內容包含社會人口學變項、牙科就醫行為與就醫經驗、牙科焦慮程度、忠誠度，及以SERVQUAL model評估醫療服務品質的5個構面，分別為有形性、可靠性、回應性、保證性及關懷性。統計方法包含獨立樣本t檢定、one-way ANOVA、Pearson相關係數及逐步淘汰複迴歸分析。結果：本研究對象的年齡平均為39.58±13.41歲，女性佔62.5%。整體而言，研究對象對醫學中心家庭牙醫科門診的醫療服務品質評估是高度正向的認同，而影響忠誠度的因素有醫療服務品質中的有形性、可靠性及保證性，及最近半年有到牙科就醫；此外，牙科焦慮程度與醫療服務品質中的保證性有負相關。結論：病人的牙科焦慮程度會影響家庭牙科門診醫療服務品質中的保證性，而牙科就醫行為與醫療服務品質會影響病人的忠誠度。

Objectives. This study aimed to determine the relationship among sociodemographic variables, dental visits, dental experience, dental anxiety, and the quality of outpatient medical services in the family dentistry department of a medical center in southern Taiwan. Methods. In this cross-sectional study, a structured questionnaire was used to facilitate patient survey and data collection from August 2020 to April 2021. A total of 144 valid responses were collected. The survey included questions on sociodemographic variables, dental and oral health visit experiences, dental anxiety, and loyalty. Moreover, the five dimensions of the SERVQUAL model were adopted in the questionnaire: tangibility, reliability, responsiveness, assurance, and empathy. Survey data were statistically analyzed using independent samples t-test, one-way analysis of variance, Pearson correlation analysis, and backward stepwise multiple regression. Results. In total, 144 participants were included in the study (mean age: 39.58±13.41 years; 62.5% females). Overall, the participants exhibited a high positive perception of the medical service quality of the family dentistry department. Loyalty, in particular, was influenced by the tangibility, reliability, and assurance of medical service quality as well as dental visits over the last 6 months. Additionally, there was a negative correlation between dental anxiety and the assurance of medical service quality. Furthermore, patients with regular dental visits had no unpleasant dental experience, and those aged 35-49 years exhibited low dental anxiety. Conclusion. In the outpatients, the assurance of medical service quality was affected by dental anxiety, whereas loyalty was influenced by dental visits and medical service quality.

1. Lu, YCA,Xu, Y,Lai, CH(2020).Assessment of patient expectation and perception of service quality and loyalty in dental services.Journal of Quality,27,281-292.
   連結：
2. Acharya, S(2008).Factors affecting dental anxiety and beliefs in an Indian population.J Oral Rehabil,35,259-267.
3. Adeniyi, AA,Adegbite, KO,Braimoh, MO,Ogunbanlo, BO(2013).Factors affecting patient satisfaction at the Lagos State University Teaching Hospital Dental Clinic.Afr J Med Med Sci,42,25-31.
4. Aldosari, MA,Tavares, MA,Matta-Machado, ATG,Abreu, MHNG(2017).Factors associated with patients' satisfaction in Brazilian dental primary health care.PloS one,12,e0187993.
5. Bahadori, M,Raadabadi, M,Ravangard, R,Baldacchino, D(2015).Factors affecting dental service quality.Int J Health Care Qual Assur,28,678-689.
6. Bovaira, M,Babiloni, AH,Jovani, M,Peñarrocha-Diago, M,González-Lemonnier, S,Peñarrocha-Oltra, D(2017).Preoperative Anxiety and Its Influence on Patient and Surgeon Satisfaction in Patients Receiving Dental Implant Surgeries Performed Under Intravenous Conscious Sedation.Int J Oral Maxillofac Implants,32,912-918.
7. Dopeykar, N,Bahadori, M,Mehdizadeh, P,Ravangard, R,Salesi, M,Hosseini, SM(2018).Assessing the quality of dental services using SERVQUAL model.Dent Res J,15,430-436.
8. Hashem, TN,Ali, N(2019).The impact of service quality on customer loyalty: A study of dental clinics in Jordan.IJMRHS,5,65-68.
9. Holtzman, J,Berg, R,Mann, J(1997).The relationship of age and gender to fear and anxiety response to dental care.Spec Care Dentist,17,82-87.
10. Humphris, GM,Morrison, T,Lindsay, SJE(1995).The Modified Dental Anxiety Scale: validation and United Kingdom norms.Community Dent Health,12,143-150.
11. Khan, AA,Siddiqui, AZ,Mohsin, SF,Mohamed, BA(2018).Sociodemographic characteristics as predictors of satisfaction in public and private dental clinics.Pak J Med Sci,34,1152-1157.
12. Lei, P,Jolibert, A(2012).A three-model comparison of the relationship between quality, satisfaction and loyalty: an empirical study of the Chinese healthcare system.BMC health services research,12,436.
13. Lin, CH,Xirasagar, S,Laditka, JN(2004).Patient perceptions of service quality in group versus solo practice clinics.Int J Qual Health Care,16,437-445.
14. Lin, CS,Lee, CY,Wu, SY(2021).Translation and validation of modified dental anxiety scale based on adult Taiwan population.BMC oral health,21,1-11.
15. Lin, DJ,Li, YH,Pai, JY(2009).Chronic kidney-disease screening service quality: questionnaire survey research evidence from Taichung city.BMC Health Serv Res,9,239.
16. Martins, AM,Ferreira, RC,Santos Neto, PED,Carreiro, DL,Souza, JGS,Ferreira, EF(2015).Users' dissatisfaction with dental care: a population-based household study.Rev Saude Publica,49,51.
17. Mills, I,Forst, J,Copper, C,Moles, RD,Kay, E(2014).Patient-centred care in general dental practice-a systematic review of the literature.BMC oral health,14,64.
18. Newsome, PRH,Wright, GH(1999).A review of patient satisfaction: 2. Dental patient satisfaction: an appraisal of recent literature.Br Dent J,186,166-170.
19. Parasuraman, A,Zeithaml, VA,Berry, L(1988).SERVQUAL: A multiple-item scale for measuring consumer perceptions of service quality.Journal of Retailing,64,12-40.
20. Parasuraman, A,Zeithaml, VA,Berry, LL(1985).A Conceptual Model of Service Quality and Its Implications for Future Research.J Mark,49,41-50.
21. Park, S,Kim, HK,Choi, M,Lee, M(2021).Factors affecting revisit intention for medical services at dental clinics.PloS one,16,e0250546.
22. Rai, NK,Tyrrell, H,Carey, C,Tiwari, T(2019).Patient perceptions in quality of care: report from university veterans clinic.BMC oral health,19,268.
23. Rezaei, S,Matin, BK,Moradi, K(2016).Measurement of Quality of Educational Hospital Services by the SERVQUAL Model: The Iranian Patients' Perspective.Electron Physician,8,2101-2106.
24. Riaz, A,Sughra, U(2021).Measurement of Service Quality Gaps in Dental Services using SERVQUAL in Public Hospitals of Rawalpindi.Pak J Med Sci,37,751-756.
25. Riley, JL, III,Gordan, VV,Hudak-Boss, SE(2014).Concordance between patient satisfaction and the dentist's view: findings from The National Dental Practice-Based Research Network.J Am Dent Assoc,145,355-362.
26. Rocha, J,Pinto, A,Batista, M,de Paula, JS,Ambrosano, G(2017).The importance of the evaluation of expectations and perceptions to improve the dental service quality.Int J Health Care Qual Assur,30,568-576.
27. Song, Y,Luzzi, L,Chrisopoulos, S,Brennan, DS(2020).Are trust and satisfaction similar in dental care settings?.Community Dent Oral Epidemiol,48,480-486.
28. Tunc, EP,Firat, D,Onur, OD,Sar, V(2005).Reliability and validity of the Modified Dental Anxiety Scale (MDAS) in a Turkish population.Community Dent Oral Epidemiol,33,357-362.
29. Wong, E,Mavondo, F,Fisher, J(2020).Patient feedback to improve quality of patient-centred care in public hospitals: a systematic review of the evidence.BMC Health Serv Res,20,530.