As the economic developing, the demanding for various kind of medical and health caring is rising for the people in Taiwan and it lead to a more competitive medical market. The average life for people in Taiwan is getting higher, nevertheless, the population that suffering from chronic diseases is growing. However, people are expecting a considerate medical service. Therefore, how to increase the service efficiency and quality, and maintain the patient¡¦s right and further rising the satisfaction are becoming important issues for the medical institutes and the government. After the National Health Service was carried out in March, 1995, an enormous and constructive change has revealed. As the government finance has getting worse, the Bureau of National Health Insurance conducted the budget control policy in July, 2002. This policy caused the profit of medical institutes was reducing and the cost was getting higher. Besides, more and more new competitors joined this medical market, and plus, people asked for a better medical service and quality, medical institute is no longer profitable. In order to improve the circumstance, the medical institutes devoted in promoting the service quality and patient¡¦s satisfaction to maintain the fully support from the patients. This research is probe to one major medical center in South of Taiwan and to invest its medical service quality and the return willing of the patient. We released 400 questionnaires and 367 returned validly, the recycling rate is 91%. We adopted SPSS for windows 17.0 as the main tool to analyze the data and get the following conclusion: the medication environment and expectation, the process and the accuracy of diagnose, the waiting and diagnose hour, the attitude of nursing staff, the diagnose service and the return willing are all obvious. Meanwhile, the hardware and software of the medical institute, the service attitude of the nursing staff is greatly affecting the return willing of the patient. Therefore, the management of medical institute should think highly of the above sectors as main strategy to increase the return willing of the patient. And we will have better medical service.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (M.S.)--University of Michigan, 1992.

Thesis (Ph. D.)--University of Sydney, 2002. / Includes tables and questionnaires. Title from title screen (viewed Apr. 28, 2008). Submitted in fulfilment of the requirements for the degree of Doctor of Philosophy to the Dept. of Public Health and Community Medicine, Faculty of Medicine. Includes bibliography. Also available in print form.

Thesis (M.P.H.M. (Primary Health Care Management))--Mahidol University, 2006. / LICL has E-Thesis 0011 ; please contact computer services.

Thesis (Ph. D.)--University of North Texas, Dec., 2008. / Title from title page display. Includes bibliographical references.

Thesis (Ph.D.)--University of Melbourne, Dept. of Medicine (RMH/WH), 2010. / Typescript. Includes bibliographical references (p. 359-392)

Patientenzufriedenheit spielt eine zunehmend wichtige Rolle im Qualitätsmanagement im Gesundheitswesen. Die ärztliche Empathie gilt dabei als ein wesentliches Element, um eine hohe Patientenzufriedenheit zu generieren. Vor dem Hintergrund abnehmender ärztlicher Empathie während der Aus- und Weiterbildung wird in der vorliegenden Arbeit untersucht, inwieweit Assistenzärzte im Vergleich zu Fachärzten die Patientenzufriedenheit in einer anästhesiologischen Prämedikationsambulanz beeinflussen. In einem prospektiv-beobachtendem Studiendesign wurden die Zufriedenheit der Patienten, deren demografische und medizinische Daten, deren vorhandene Vorinformationen sowie organisatorische und logistische Faktoren mithilfe eines selbst erstellten ZUF-8 adaptierten Fragebogens erhoben und anhand des Ausbildungsstandes des prämedizierenden Arztes der Assistenz- oder Facharztgruppe zugeteilt. Dabei zeigten sich Gesamtzufriedenheitswerte auf durchgehend hohem bis sehr hohem Niveau. Feine Unterschiede zugunsten der Assistenzärzte wurden in den Items Gesprächsqualität, Allgemeinzufriedenheit und Freundlichkeit gefunden. Im Bereich der organisatorischen und logistischen Faktoren ergaben sich u.a. länger empfundene Wartezeiten bei den Assistenzärzten. Abschließend macht diese Arbeit deutlich, dass Assistenzärzte im Vergleich zu Fachärzten trotz abnehmender ärztlicher Empathie eine gleichweg hohe Patientenzufriedenheit generieren können. Eine Verbesserung der organisatorischen Abläufe könnte eine weitere Optimierung der Patientenzufriedenheit versprechen.

INTRODUÇÃO: Pacientes portadoras de obesidade mórbida submetidas a tratamento cirúrgico através de cirurgias disabsortivas-restritivas, após considerável perda ponderal, evoluem com dobras cutâneas ou dermogordurosas em várias regiões do corpo. As mamas são caracterizadas pela deficiência de volume, ptose acentuada, assimetria e medialização dos complexos aréolo-papilares. A mastopexia com inclusão de implantes mamários tem demonstrado ser solução cirúrgica eficaz para melhora da forma, volume e simetria das mamas. OBJETIVO: Avaliar a satisfação das pacientes e os resultados cirúrgicos obtidos após a mastopexia com inclusão de implantes mamários. MÉTODOS: Vinte pacientes do sexo feminino, com média etária de 39,9 anos, foram submetidas à mastopexia com inclusão de implantes mamários entre setembro de 2008 e abril de 2009. Foram aplicadas entrevistas psicológicas semidirigidas a todas as pacientes, nos períodos pré e pós-operatórios, cujas respostas foram tabuladas, divididas em categorias, e possibilitaram a avaliação da satisfação das pacientes. Foi realizada avaliação dos resultados cirúrgicos através da análise fotográfica por três cirurgiões plásticos independentes, nos períodos pré e pós-operatórios, onde foram atribuídas notas zero, um ou dois, para os seguintes itens: forma da mama, volume da mama, simetria entre as mamas, posicionamento do complexo aréolo-papilar e qualidade e extensão das cicatrizes. RESULTADOS: Dezenove pacientes (95%) referiram satisfação com o resultado cirúrgico obtido (p<0,001). Quatro pacientes (20%) relataram melhora da vida profissional; doze pacientes (60%), melhora da vida social; dez pacientes (50%), da vida afetiva; e dez pacientes (50%), da vida sexual. A média das somatórias das notas atribuídas pelos três cirurgiões, referentes a cada paciente, variou entre 4,7 e 10, sendo a média geral de 7,28. Os resultados foram considerados bom ou ótimo para 65% da amostra e pobre para 8,4%. CONCLUSÕES: Houve satisfação de 95% das pacientes com os resultados obtidos pela mastopexia com inclusão de implantes. A análise fotográfica dos resultados obteve nota média de 7,28, caracterizado como bom resultado, apesar da fraca concordância entre os avaliadores. / INTRODUCTION: Morbid obesity patients submitted to surgical treatment through disabsortive-restrictive procedures, and after considerable weight loss, develop skin or fatty tissue folds in many regions of the body. These changes in the breasts, in particular, are characterized by volume deficiency, marked ptosis, asymmetry and medialization of the nipple-areola complexes (NAC). Mastopexy associated with breast implant inclusion has shown to be an efficient solution to improve shape, volume and breast symmetry. OBJECTIVE: To evaluate patient satisfaction and surgical results obtained after mastopexy with breast implant inclusion. METHODS: Twenty female patients with a mean age of 39.9 years were submitted to mastopexy with breast implant inclusion between September 2008 and April 2009. All patients had semi-directed psychological evaluation in the pre- and postoperative periods. The answers to the evaluations were tabulated, categorized, and allowed patient satisfaction analysis. The surgical results evaluation was made through photographic analysis of three independent plastic surgeons, in the pre- and post-operative periods, when scores of zero, one or two, were attributed to the following items: breast shape, breast volume, symmetry of breasts, NAC position, scar quality and extent. RESULTS: Nineteen patients (95%) referred satisfaction with the surgical results attained (p<0,001). Four patients (20%) referred improvement in their professional lives; twelve patients (60%), improvement in their social lives; ten patients (50%), of their affective lives; and ten (50%) of their sexual lives. The mean sum of the scores attributed by the three surgeons, respective to each patient, varied between 4.7 and 10, with an overall mean of 7.28. The results were considered good or great for 65% of the sample and poor for 8.4%. CONCLUSIONS: There was a 95% satisfaction rate among patients with the results obtained through Mastopexy with breast implant inclusion. The photographic analysis of the results obtained a mean score of 7.28, considered as a good result, albeit the weak correlation among evaluators.

INTRODUÇÃO: Pacientes portadoras de obesidade mórbida submetidas a tratamento cirúrgico através de cirurgias disabsortivas-restritivas, após considerável perda ponderal, evoluem com dobras cutâneas ou dermogordurosas em várias regiões do corpo. As mamas são caracterizadas pela deficiência de volume, ptose acentuada, assimetria e medialização dos complexos aréolo-papilares. A mastopexia com inclusão de implantes mamários tem demonstrado ser solução cirúrgica eficaz para melhora da forma, volume e simetria das mamas. OBJETIVO: Avaliar a satisfação das pacientes e os resultados cirúrgicos obtidos após a mastopexia com inclusão de implantes mamários. MÉTODOS: Vinte pacientes do sexo feminino, com média etária de 39,9 anos, foram submetidas à mastopexia com inclusão de implantes mamários entre setembro de 2008 e abril de 2009. Foram aplicadas entrevistas psicológicas semidirigidas a todas as pacientes, nos períodos pré e pós-operatórios, cujas respostas foram tabuladas, divididas em categorias, e possibilitaram a avaliação da satisfação das pacientes. Foi realizada avaliação dos resultados cirúrgicos através da análise fotográfica por três cirurgiões plásticos independentes, nos períodos pré e pós-operatórios, onde foram atribuídas notas zero, um ou dois, para os seguintes itens: forma da mama, volume da mama, simetria entre as mamas, posicionamento do complexo aréolo-papilar e qualidade e extensão das cicatrizes. RESULTADOS: Dezenove pacientes (95%) referiram satisfação com o resultado cirúrgico obtido (p<0,001). Quatro pacientes (20%) relataram melhora da vida profissional; doze pacientes (60%), melhora da vida social; dez pacientes (50%), da vida afetiva; e dez pacientes (50%), da vida sexual. A média das somatórias das notas atribuídas pelos três cirurgiões, referentes a cada paciente, variou entre 4,7 e 10, sendo a média geral de 7,28. Os resultados foram considerados bom ou ótimo para 65% da amostra e pobre para 8,4%. CONCLUSÕES: Houve satisfação de 95% das pacientes com os resultados obtidos pela mastopexia com inclusão de implantes. A análise fotográfica dos resultados obteve nota média de 7,28, caracterizado como bom resultado, apesar da fraca concordância entre os avaliadores. / INTRODUCTION: Morbid obesity patients submitted to surgical treatment through disabsortive-restrictive procedures, and after considerable weight loss, develop skin or fatty tissue folds in many regions of the body. These changes in the breasts, in particular, are characterized by volume deficiency, marked ptosis, asymmetry and medialization of the nipple-areola complexes (NAC). Mastopexy associated with breast implant inclusion has shown to be an efficient solution to improve shape, volume and breast symmetry. OBJECTIVE: To evaluate patient satisfaction and surgical results obtained after mastopexy with breast implant inclusion. METHODS: Twenty female patients with a mean age of 39.9 years were submitted to mastopexy with breast implant inclusion between September 2008 and April 2009. All patients had semi-directed psychological evaluation in the pre- and postoperative periods. The answers to the evaluations were tabulated, categorized, and allowed patient satisfaction analysis. The surgical results evaluation was made through photographic analysis of three independent plastic surgeons, in the pre- and post-operative periods, when scores of zero, one or two, were attributed to the following items: breast shape, breast volume, symmetry of breasts, NAC position, scar quality and extent. RESULTS: Nineteen patients (95%) referred satisfaction with the surgical results attained (p<0,001). Four patients (20%) referred improvement in their professional lives; twelve patients (60%), improvement in their social lives; ten patients (50%), of their affective lives; and ten (50%) of their sexual lives. The mean sum of the scores attributed by the three surgeons, respective to each patient, varied between 4.7 and 10, with an overall mean of 7.28. The results were considered good or great for 65% of the sample and poor for 8.4%. CONCLUSIONS: There was a 95% satisfaction rate among patients with the results obtained through Mastopexy with breast implant inclusion. The photographic analysis of the results obtained a mean score of 7.28, considered as a good result, albeit the weak correlation among evaluators.