In Taiwan, the nephritis, nephrotic syndrome and chronic renal failure are occupied the eighth of compatriot's ten major causes of the death; Due to medical improvement in recent years, end stage renal disease with long term hemodialysis patients were increasing day by day, the dialysis cost also go up year by year. According to the statesment of Bureau of National Health Insurance, the whole Taiwan dialysis patients were about 50,000 persons, expensed 28,100 million dollars in one year , each dialysis patient expense 600,000 dollars every year on average, it is the first of clinical expenses . In recent years, the dialysis suppliers get involved in the business of the dialysis clinics, they already were not only the large international factory for selling dialysis material, but also get involved in dialysis clinics about dealing , buying and combining resources, so the dialysis clinics form the two kinds of different manageable type :dialysis supplier and independent operator. This research was cross- sectional study and divided dialysis clinics into dialysis supplier and independent operator, the study choose the different kinds of dialysis clinic patients as samples from Kaohsiung and Pingtung area and carry on the interview of questionnaire by the bedside. Through analyzing the patient¡¦s idiosyncrasy, affect patients in choosing health care providers, patient's satisfaction, life quality, life impact after kidney disease and paying medical care quality indicator of dialysis clinics (average serum albumin with the whole people's clinic of health insurance, dialysis efficiency equally to life), probe into the difference between two kinds of different manageable type of dialysis clinics. The descriptive statistical analysis, explored factor analysis, dependent sample analysis of variance, independent sample analysis of variance and Pearson product-moment correlation analysis, etc. method were employed as statistical analysis. The result of study found, the top five expected satisfaction level of hemodialysis patient were avablility to the peritoneum dialysis service, avablility to consultation of kidney transplantation , medicine safe to value , nutritionist for diets consultation , the availability of nephrology specialists , the expected satisfaction level relatively lean to the professional service , but patient satisfaction relatively lean to the hardware service actually. The whole satisfaction of independent operator in the operation service , professional service , extra service , public relations , geographical position are all superior to dialysis suppliers. The dialysis supplier was superior to the independent operator only in the hardware service. Through this research, hope to make the officer in dialysis center, realize the demand of patients,and offer better service as improving direction in medical quality.

Due to the development of society, the rise of living standards, the increase of population, the availability of information, and the establishment of health care systems, the medical industry is not as prestigious as it was in the past. Under the economy where the market is changing from supplier-oriented to consumer-oriented, competitions between various medical facilities and patients¡¦ demands for better medical care quality grow, which then result in the rise of medical risks. Medical institutions no longer just focus on the treatment effects, but must also fully understand the conditions of the patients and effectively manage and utilize the resources at hand in order to raise the treatment quality and to stand above other competitors. The purpose of this research is to identify the various factors that prompt patients to seek medical treatments, and to raise patients¡¦ satisfaction and faithfulness towards medical institutions. The research was carried out using a survey/questionnaire approach. Patients that have been to two or more dental clinics were asked to participate in the survey, and those who were interested were chosen. The PZB service quality SERVQUAL scale was used. Out of the 150 questionnaires distributed, 123 were retrieved (82%), and 111 of those retrieved were valid for consideration (74%). The survey showed that (1) a gap exists between patients¡¦ expected treatment service and the actual service received; (2) patients hold high expectation towards the service quality; (3) patients decision to switch clinics partially depends on the received service; (4) the main factor that prompt patients to switch clinics is their concerns towards the ability of their doctors/physicians; (5) Instead of the actual service, assurance and reliability are more essential to the patients; and (6) clinics showing sincerity and making sure the patients feel secure are most important towards the patients. The research concludes that patients choose their medical institutions base on the received services. The five aspects of service all have almost equal importance, and all are influential towards patients¡¦ choices of medical institutions.

This thesis is concerned with the quality of care for the elderly in nursing homes, responding to a critical social and demographic imperative. The aim of this study is to provide a service quality construct for nursing homes to increase client focus and satisfaction. The research is underpinned by the service quality literature. It utilises the SERVQUAL construct to explore the nature of service quality in nursing homes through semi-structured interviews with nursing home residents and resident's families. A service quality scale was constructed comprising six dimensions and 27 scale items capturing service delivery in nursing homes. This scale was purified through a survey of residents and family members (n=263). Through exploratory factor analysis, six importance and four experience factors were identified. Regression analysis was used to identify relationships between the factors, service quality and satisfaction. The results indicate that importance does not predict perceived quality, though experience of responsiveness and hospitality and courtesy and personal approach are indicators of service quality. Furthermore, quality emerges as a predictor of satisfaction. From these outcomes, a service quality construct was developed which comprises of service marketing and service quality dimensions. This thesis contributes to the construction of the concept of service quality in nursing homes, its dimensionality and thus the precursors of satisfaction. These have considerable implications for the management of nursing home services.homes, its dimensionality and thus the precursors of satisfaction. These have considerable implications for the management of nursing home services.

Quality-based payment in healthcare—also known as pay-for-performance—is a popular policy intervention aimed at improving healthcare quality. However, there has been little theoretical work characterizing the underlying quality problem or the interaction between pay-for-performance and existing payment mechanisms. Furthermore, there is little empirical evidence that pay-for-performance has a substantial effect on healthcare quality.

Public Health Management Personnel‘s Attitude Towards the Implementation of the Quality System in a Hospital Reda Ambrazeviciene Scientific adviser Dr. Ilona Buciuniene Kaunas Medical University, Public Health Faculty, Department of Social Medicine.- Kaunas, 2005.-75 p. Aim of the work. To analyse personnel‘s attitude towards the implementation of the quality system in a hospital. Tasks. To estimate the level of the personnel participation in the implementation of the quality system and the attitude toward patients; as well as participation in the process of health care provision; to find out personnel’s attitude towards the main quality system’s documents that describe the work process; to give the recommendations of how to improve the implementation of the quality system in the surgery departments in hospitals. Methodics of the Research. Object of the research – personnel‘s of the surgery departments attitude towards quality improvement. Research methods – analysis of the newest Lithuanian and foreign scientific literature and juridical documents, questioning the personnel. Questionnaire was given to personnel members at the surgery department; the return rate was 69,93 per cent. Methods of the statistical analysis – statistical significance of the data was measured by the criteria χ², number of the freedom degree (df) and the statistical significance. Responses to the questions and statements were analysed by the method of averages. Difference between several different... [to full text]

Darbo tikslas. Įvertinti ligoninės gydytojų ir slaugytojų požiūrį į bendradarbiavimą ir kokybės vadybos sistemą įstaigoje. Uždaviniai. Įvertinti gydytojų ir slaugytojų požiūrį į bendradarbiavimą ir kokybės vadybos sistemą įstaigoje, palyginti gydytojų ir slaugytojų požiūrį į bendradarbiavimą ir kokybės vadybos sistemą, nustatyti gydytojų ir slaugytojų požiūrio į bendradarbiavimą įstaigoje ryšį su pasitikėjimu kitais darbuotojais ir pasitenkinimu darbu. Tyrimo metodika. Anoniminė vienos įstaigos gydytojų ir slaugytojų apklausa (n=256). Statistinei duomenų analizei taikytas hipotezės apie dviejų požymių nepriklausomumą tikrinimas susietų lentelių metodu naudojant chi kvadrato kriterijaus reikšmę. Rezultatai. Didžioji dalis medikų mano, jog partnerystė tarp sveikatos priežiūros darbuotojų gali pagerinti pacientams teikiamų paslaugų kokybę, paslaugų prieinamumą, darbuotojų pasitenkinimą darbu ir darbuotojų gyvenimo kokybę. Statistiškai reikšmingai didesnė dalis slaugytojų (50,9 proc.) nei gydytojų (35,8 proc.) nurodo, jog pasikeitimas informacija tarp gydytojų ir vadovų pakankamas, 71,7 proc. gydytojų ir 44,8 proc. slaugytojų teigia, jog informacija tarp gydytojų ir slaugytojų yra pakankama. 70,8 proc. medikų nurodo, jog jų įstaigoje yra įdiegta kokybės vadybos sistema. 50,6 proc. medikų yra patenkinti, 48,8 proc. - iš dalies patenkinti savo profesija. 63,6 proc. medikų savo pasitikėjimą kolegomis bei vadovais vertina teigiamai, 11,5 proc. – neigiamai. 54,2 proc. patenkintų... [toliau žr. visą tekstą] / Aim of the study. To investigate attitude of health care professionals towards partnership and quality management system in health care institution. Objectives. To assess attitudes of health care professionals towards partnership and quality management system, to compare attitudes of physicians and nurses towards partnership and quality management system, to evaluate associations of attitudes to partnership with trust and job satisfaction among physicians and nurses. Methods. An anonymous questionnaire survey was performed including all physicians and nurses working in one health care institution (n = 256). Statistical calculations of chi square’s test was performed. Results. The majority of health care professionals state that partnership among medical staff can improve quality of health care services provided to the patients, accessibility of the services, job satisfaction and quality of life of medical staff. The major part of nurses (50.9 percent) than physicians (35.8 percent) indicate, that information level between physicians and managers is sufficient, the major part of physicians (71.7 percent) than nurses (44.8 percent) note that information level between physicians and nurses is sufficient. 70.8 percent of respondents point that system of quality assurance is implemented in their institution. 50.6 percent of medical staff is satisfied and 48.8 percent – partly satisfied with job. 63.6 percent of respondents trust and 11.5 percent distrust in their colleagues... [to full text]

Includes one computer disk in Work 6 format. / System requirements for accompanying computer disk: Mackintosh or IBM-compatible computer. Other requirments: Microsoft Word 6 or compatible Word Processor. / Bibliography: leaves 241-270. / xiii, 270, [47] leaves ; 30 cm. + 1 computer disk (3 1/2 in.) / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (Ph.D.)--University of Adelaide, Graduate School of Management, 1999

Diss. (sammanfattning) Linköping : Univ., 2002. / Härtill 5 uppsatser.

Diss. (sammanfattning) Uppsala : Uppsala universitet, 2005. / Härtill 4 uppsatser.

Thesis (M.H.A.)--University of Michigan, 1974.