臺灣博碩士論文加值系統

全民健保開辦以來，健保局為落實醫藥分業，並方便大眾就醫， 對於病情穩定需長期服用相同藥品之慢性病患者例行領藥，如經特約醫療機構醫師確認慢性病病情穩定，僅須長期使用同一處方藥品調劑，就可以開立連續處方箋，由病患持至醫院、診所或健保特約藥局調劑。然而，慢性病連續處方箋之開立，除醫療院所之主動釋出外，亦須慢性病患對其具備正確之認知，並願意持續運用該處方箋至社區藥局調劑，方能使此項政策落實。
本研究以慢性病患為研究對象，探討其對慢性病連續處方箋認知及社區藥區藥事服務之認知、滿意度及持續使用意願之關聯程度。獲致以下結論：
一、人口統計變項對於慢性病連續處方箋之認知、對於社區藥局藥事服務之認知、滿意度、再購意願，均無顯著差異。
二、慢性病連續處方箋使用知識中，「連續兩次領藥間隔」及「出國一次最多領取月數」認知正確者最少，對此二項認知愈低者，對社區藥局藥事服務之滿意度也愈低。
三、社區藥局藥事服務認知可區分為藥師服務認知及藥師調劑認知二個分量表，研究結果顯示，藥師藥事服務認知及藥師調劑認知對社區藥局藥事服務滿意度之關係均為正向，即認知愈高，其滿意度就愈高。
四、社區藥局之藥事服務滿意度對社區藥局藥事服務再購意願的關係為正向，即社區藥局之藥事服務滿意度愈高，其社區藥局藥事服務再購意願就會愈高。
根據研究結果，本研究建議應對認知正確者最少之「連續兩次領藥間隔」及「出國一次最多領取月數」等慢連基本知識加強宣導，以提升患者之滿意度，進一步提高其再調劑意願，以達到民眾醫療持續照護及落實政策美意之雙贏局面。

To fulfill the Separation of Dispensing Practice Policy and convenience of medical care, the Bureau of National Health Insurance enacted chronic illness prescription slip for patients getting long-term prescribed medicine from NHI contracted community pharmacy. However, the success of the policy should be compliant with patients’ cognition of chronic disease refill prescriptions and their cognition, satisfaction, and repurchasing willingness of community pharmacy.

The purpose of this study was to investigate the relationship among cognition, satisfaction, and repurchasing willingness of chronic disease patients. The results showed as follows:
1.The personal traits of patients will not affect their cognition of chronic-disease refill prescriptions and their cognition, satisfaction, and repurchasing willingness of community pharmacy.
2.The poorest cognition of the knowledge of chronic-disease refill prescriptions usage is “interval between two refill” and “upper limit of refill before abroad”.
3.The cognition of pharmaceutical service of community pharmacy was divided into two sub-measures: cognition of pharmaceutical service of pharmacist and cognition of dispensing service of pharmacist. Both cognitions have positive effect on satisfaction.
4.Patients’ satisfaction has positive effect on patients’repurchase.

目錄
中文摘要.................................................I
英文摘要................................................Ⅲ
誌謝....................................................Ⅳ
目錄....................................................Ⅴ
表目錄..................................................Ⅶ
圖目錄..................................................Ⅷ
第一章 緒論.............................................1
第一節 研究背景..............................................................................1
第二節 研究動機..............................................................................3
第三節 研究目的..............................................................................6
第四節 研究流程..............................................................................7
第二章 文獻探討.........................................8
第一節 慢性病連續處方箋與社區藥局.........................................8
第二節 消費行為的認知................................................................11
第三節 滿意度................................................................................14
第四節 再購意願............................................................................17
第五節 認知、滿意度及再購意願之關聯...................................17
第三章 研究方法........................................21
V
第一節 研究架構與假說................................................................21
第二節 研究設計............................................................................24
第三節 資料分析方法....................................................................24
第四節 問卷設計............................................................................26
第四章 研究結果分析....................................32
第一節 樣本資料說明及敘述性統計分析...................................32
第二節 量表因素分析....................................................................36
第三節 問卷量表信度檢測...........................................................38
第四節 慢連使用知識對社區藥局藥事服務滿意度之影響.......38
第五節 藥事服務認知對社區藥局藥事服務之滿意度...............42
第六節 社區藥局藥事服務滿意度對藥事服務之再購意願.......44
第五章 結論與建議.....................................46
第一節 研究結論............................................................................46
第二節 研究建議............................................................................48
參考文獻................................................50
一、中文部份....................................................................................50
二、英文部份....................................................................................52
附錄....................................................55
VI
表目錄
【表1- 1】2007台灣地區十大死亡原因統計...................................................2
【表2- 1】顧客滿意度之相關文獻..................................................................15
【表3- 1】Cronbach’s α值的意義.....................................................................25
【表3- 2】慢性病連續處方箋使用知識之認知問項......................................27
【表3- 3】社區藥局之藥事服務認知問項......................................................28
【表3- 4】社區藥局藥事服務滿意度問項......................................................29
【表3- 5】社區藥局藥事服務再購意願問項..................................................29
【表3- 6】人口統計變項問項..........................................................................30
【表3- 7】「社區藥局之藥事服務認知」Person積差相關表.......................31
【表3- 8】「社區藥局藥事服務滿意度」Person積差相關表.......................31
【表4- 1】人口統計特性之敘述性統計..........................................................32
【表4- 2】慢連使用知識各題正確認知率統計…………………...…………34
【表4- 3】慢連使用知識答對率統計..............................................................34
【表4- 4】社區藥局藥事服務認知率統計......................................................35
【表4- 5】「社區藥局藥事服務認知量表」的因素分析..............................37
【表4- 6】各研究構面之Cronbach’s α值.........................................................38
【表4- 7】慢連使用知識對社區藥局藥事服務之滿意度分析......................40
【表4- 8】慢連使用知識對社區藥局藥事服務滿意度之迴歸分析..............41
【表4- 9】藥師服務認知對社區藥局藥事服務滿意度之迴歸分析..............42
【表4- 10】藥師調劑認知對社區藥局藥事服務滿意度之迴歸分析............43
【表4- 11】社區藥局藥事服務滿意度對社區藥局藥事服務再購意願之迴歸分析....................................................................................44
VII
圖目錄
【圖1- 1】研究流程............................................................................................7
【圖3- 1】研究架構..........................................................................................23

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