To increase medical service quality for medical ecology is necessary nowadays, it provides not only customers satisfaction and ensure patent s¡¦ willing for next visit, but also have the requirements of the hospital accreditation. Furthermore, medical service quality has become the main purchasing direction for hospital administrators. This survey is based on ¡§5Q model for different dimensions¡¨ by Zineldin (2006), including quality of object, quality of processes, quality of infrastructure, quality of interaction, quality of atmosphere. However, it evaluates which medical service quality that may affect patient¡¦s satisfaction and loyalty for having examination check in radiological department. The result of this research can be used by the hospital to provide the medial service quality, hospital competitiveness, sustainable development, and to supply more effective strategies in future direction. This survey investigated the patients for the examination of medical imaging from the biggest military hospital in southern, which was assessed as a regional Teaching Hospital by department of Health, the executive Yuan. A total of 600 questionnaires were sent out to patients, with 586 valid samples, and with 14 uncompleted invalid samples. The effective response rate is about 97.9%. In this study, the quality of medical service is based on five dimensions analysis, respectively patient satisfaction and patient loyalty. In addition, the patient satisfaction provided analysis and discussion for patient loyalty. The research was the participants with medical treatment from military hospital and was carried the analysis in order to further understand the significant difference in the causes for medical treatment, medical service quality, patient satisfaction and royalty. The research is summarized as follows: 1.The medical service quality ¡§quality of object, quality of processes, quality of infrastructure, quality of interaction, quality of atmosphere. ¡§ were all positive and significant influence on patient satisfaction, particularly quality of atmosphere and quality of interaction. 2. The quality of object, quality of interaction, quality of atmosphere had also strong and positive impact on the loyalty of the patients, but the quality of process, and the quality of infrastructure hadn¡¦t affect the patients¡¦ loyalty remarkably. 3. In addition, patient satisfaction appeared a relevant and significant impact on patient loyalty. 4. For treatment reasons, people who were military and military dependents were significant higher than the patients who live closely to hospital for quality of object, quality of infrastructure, quality of interaction, quality of atmosphere and patient satisfaction.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Patients are the key stakeholders in health care providers and it is extremely important to increase their satisfaction level. Patient satisfaction is a subject of great interest to the health care providers and researchers alike. As there are a lot of factors related to health care providers that causes patient selection and rejection. Since competition has increased in recent years, this exerts more pressure on health care providers to render more improved service quality in addition to build trust and gain high reputation. Improved quality of service has now become an important aspect of patient satisfaction, building trust is now a crucial milestone and gaining high reputation is considered the key for any health care provider. In practice and theory it has been proven that service quality dimensions, trust and reputation is related to patient satisfaction. For this, we took 5Q model of the service quality combine with trust and reputation, and how it affects patient satisfaction is the main theme of the study. Purpose: The purpose of this study is to investigate that how 5Q model of the service quality, trust and reputation can effect patient satisfaction in health care sectors, for this study we researched Umeå hospital. This research is focused towards exploring the perceptions of patients who consume or undertook Umeå hospital services. It also provides an effective model for health care organization in practice and the study also contribute to literature from educational point of view.  Method: In this study hypothesis developed to investigate how 5Q model of the service quality, trust and reputation can effect patient satisfaction. For service quality 5Q model was used while several attributes were taken for trust and reputation to investigate the patient perception. Quantitative research strategy was adopted and convenience sampling technique was used to collect quantitative data from patients of Umeå hospital to get their satisfaction levels. Hypotheses were tested by using multiple regression analysis to the obtained data in SPSS. Findings: The study revealed interesting results for patient satisfaction regarding the 5Q model of the service quality, trust and reputation. Meanwhile 5Q model was used for service quality, which composes quality of object, quality of process, quality of infrastructure, quality of interaction and quality of atmosphere. Out of five dimensions, two gave positive effect and three gave no effect result by the patient for their satisfaction from the Umeå hospital. Trust gave no effect result, whereas reputation gave positive effect result by the patient for their satisfaction from the Umeå hospital. Implication/Contribution: The findings imply that 5Q model of the service quality is not the only factor that could lead to patient satisfaction in health care sectors but trust and reputation are also factors of great importance. Organizations need to improve every dimension of service quality, creating trust and achieve high reputation to gain high level of patient satisfaction. This study contributes to existing theories by confirming or adding value that have positive effect on patient satisfaction. 5Q model is a comprehensive model and it needs to be implemented in health care sector but with additional factors i.e. trust and reputation.  Key words: Patient satisfaction, Service quality, 5Q model, Trust, Reputation, Health care providers.

The trend in medical education and in general, among health professionals, is based, on the current changes of health systems aimed to improve relevance equity, and cost effectiveness of health care. With respect to human health resources, there is lack of agreement among the competence level, performance and the needs of both the system using them and the target population. Therefore, it is important and necessary to consider both the community and health services as partners in the task of defining these changes and in the provision of health services to meet the above mentioned criteria. / The main purpose of this partnership is to encourage efforts to promote, oversee, and apply the actions in each one of the instances in order to improve training of human resource, strengthen local health systems, and empower the communities. Human resource competence and performance, the capacity to provide services, and the degree of community participation and commitement to health, are key elements in improving service quality. / The philosophy of current curricula reform at the Valle University stresses the partnership relationship between academic institutions, services centers, and the community, in the training of health professionals. The proposed investigation focuses on the community-based training aspect of student performance assessment and its relation to the health care system and academia. Specifically, the study will focus on designing valid and reliable instruments for community assessment of student performance, using both qualitative and quantitative aspects of data collection and analysis to assess "patient satisfaction" as an indicator of quality of care. / The results of this study demonstrate that the proposed assessment activity will allow the educational and health services institutions to have relevant and dynamic information as feedback for planning and adjustment of their programs. At the same time, it will allow the community to participate in an effective way in aspects related to their health care. The results of this study will be used as a basis for producing guidelines for involving communities (users) in the health care students evaluation process.

Thesis (M.Tech.:Chiropractic)-Dept. of Chiropractic, Durban Institute of Technology, 2006 x, 65 leaves, Annexures A-H / Patient satisfaction is an important, desired measure of quality of care and has a significant influence on the perceived quality of care and outcome of treatment, and for this reason, it holds great value to the treating clinician. Satisfied patients are more likely to comply with treatment instructions and advice, remain with their service provider and refer others. Dissatisfaction, in the event of an unfavourable outcome, can result in legal action and complaints to regulatory bodies. Studies have indicated a high level of satisfaction with chiropractic care; however, none have been in a student clinic setting even in view of the suggested importance in the literature. In view of this significance and lack of understanding of the patients’ satisfaction / dissatisfaction in the history of DIT’s clinic operation the question remains as to what extent the students at the DIT Chiropractic Day Clinic satisfy their patients. This study evaluated the patient satisfaction at the DIT Chiropractic Day Clinic in order to establish a baseline for future comparison. Cronbach’s alpha scores were used to determine questionnaire reliability in a South African student context.

The aim of this study was to describe the clients' satisfaction with Primary Health Care (PHC) Services in Lilongwe Health District with regard to client involvement in health care delivery and the accessibility of PHC services. It was hoped that the information generated would be used in the evaluation of PHC Services in Lilongwe. A quantitative and qualitative research was done using an outcome analysis evaluation design. The study utilised Kawale and Chiwamba Health Centres and their catchment population. Systematic random sampling was used for the clients making use of the health centres, convenience sampling for those not using the health centres and purposive sampling for the focus group participants. Quantitative data was collected using self-administered questionnaires while qualitative data was collected using an interview guide in focus group sessions. Quantitative data was analysed using SPSS and percentages and frequencies were calculated while qualitative data was analysed through a template style of analysis. The findings of the study revealed that in both Health Centres Clients were satisfied with some aspects of PHC such as, cultural accessibility, health education and listening abilities of health workers but there was still some evidence of dissatisfaction, and misunderstanding of the concept of Community Involvement in Health care delivery. This calls for a need to reorient communities on PHC delivery and what it means. / Thesis (M.N.)-University of Natal, Durban, 2004.

För att primärvården ska kunna utvecklas är det viktigt att den har patienternas förtroende. Därför är det av stor betydelse att undersöka vad som påverkar om befolkningen känner att de har möjligheten att få den vård de behöver. Denna uppsats undersöker hur två faktorer påverkar andelen invånare som anser sig ha tillgång till den vård de behöver. De två faktorerna är primärvårdens nettokostnader, samt hur stor andel av dessa kostnader som kan hänföras till köpt vård från privata företag. Dessa samband undersöks genom att flera modeller formuleras. För att modellerna skall kunna skattas används paneldata över Sveriges landsting samt åren 2005 t.o.m. 2012. Modellerna skattas med ordinarie minsta kvadratmetoden. Studien kan inte fastställa något samband mellan de två undersökta variablerna och andelen invånare som anser sig ha tillgång till den vård de behöver. Däremot verkar det finnas ett samband mellan vårdval i primärvården och andelen invånare som anser sig ha tillgång till den vård de behöver. / In order to develop it is important for primary care to have the patients trust. Therefore, it is of great importance to investigate what influences if the population feel they have access to the health care they need. This paper examines the influence of two factors on the proportion of residents who feel they have access to the health care they need. The two factors are net cost of primary health care and the proportion of these costs that can be assigned to purchases of care from private companies. These relationships are examined by serval formulated models. To estimate the models, panel data of Swedish County Councils and the years 2005 to 2012 are used. The models are estimated with ordinary least squares method. The study cannot find a link between the two examined variables and the percentage of residents who feel they have access to the care they need. However, it seems to be a correlation between free choice of primary health care and the percentage of residents who feel they have access to the care they need.

Background: Contracting asexually transmitted disease is strongly associated with stigmaand shame. Stigma associated with these diseases has a significant impact on self-image andpropensityto seek care. Despitehigh incidencethere is a generallack of awareness about therisks and theeffectsthatthese diseases have on both mental and physical health. Health carepersonnel are experiencing difficulties to meet and care for these patients. Aim: The aim ofthis studyisto describe patients'experiences of health care after they were diagnosed with asexually transmitted disease. Method: The study was conducted as a systematic literaturereviewbased on tenoriginal articles. Ameta-synthesiswas used for the analysisandthe resultwasdiscussedwithHalldórsdóttir's (1996) theory;"Caring and Uncaring Encounters inNursing and Health Care–From the Patients Perspective". Result: Five themes emerged;The importance of emotional support;Beingjudged by the health personnel; The importanceof information;To (not) talk about sexandThe environmentalimpact on the confidentiality.Conclusion:Patients with sexually transmitted diseasesare experiencingencounters withhealth care bothnegativelyand positively, although there were mostlynegative experiencesofthe encounters. Several factors affect patients' experiences.Encounter with health care affectspatients' well-being and health. Clinical significance: The knowledge fromthis studymightenable a patientcentredapproach. Based on this knowledge,healthcouldbe developed so thatthe encounter itselfpromotesempowerment and an increased sense of well-being and health. / Bakgrund: Att få en sexuellt överförbar sjukdom är tydligt förknippatmed stigma och skam. Stigma har en betydande påverkan på individens självbild och benägenhet att testa sig. Trots hög incidensidentifieras en generellt bristande medvetenhet om de risker och effekter dessa sjukdomar har påbåde psykisk och fysisk hälsa. Vårdpersonal upplever svårigheter att bemötapatienter med sexuellt överförbara sjukdomar. Syfte: Studiens syfte är att beskriva patientersupplevelser av mötet med vården efter att de diagnostiserats meden sexuellt överförbarsjukdom. Metod: Studien genomfördes som en systematisk litteraturöversikt där tio originalartiklar sammanställdes med en metasyntes och diskuterades utifrån Halldórsdóttirs (1996) teori;"Vårdande och icke-vårdande möteni omvårdnad och hälso-och sjukvård–utifrån ett patientperspektiv". Resultat: Fem teman framkom som återkommande upplevelser; Betydelsen av emotionellt stöd; Att bli dömd av vårdpersonalen, Betydelsen avinformation; Att (inte) tala om sex och Den fysiska miljöns påverkan på konfidentialiteten. Slutsats: Patientermed sexuellt överförbara sjukdomar upplever mötet med vården ivarierande grad negativt och positivt. Dock framkom det övervägande negativa upplevelser av mötet. Flertalet faktorer påverkar patienternas upplevelse. Mötet med vården påverkar patienternas välbefinnande och hälsa. Kliniskbetydelse: Kunskapen från resultatet i denna studie kan möjliggöra en patientcentrerad vård. Utifrån resultatet kan vården utvecklas så att mötet upplevs som vårdande, och där mötet i sig samt kontakten med vården skapar egenmakt och en ökad känsla av välbefinnande och hälsa.