Cac nhan to anh hu'dng den su* hai long cua ngu'o^i dan
doi v6i chat lu'gfng djch vu kham, chu'a benh tai Benh vien da khoa
• • • •
Pho' Noi, tinh Hutie Yen
^ NGaYlri THI MO*
N G G Y I N TH! NGQC YEW Tdm tat
Bdi vie't nghien cffu cdc nhdn td'dnh hudng den sU hdi ldng cua ngUdi ddn dd'i vdi chdt lugng dich vu khdm chffa benh tgi Benh viin da khoa Phd Nd'i. ttnh Hung Yen. Ki't qud nghien cffu cho thdy, co 5 nhdn tddnh hudng de'n sU hdi long cua ngUdi ddn ddi vdi chdt lUang dich vu khdm. chffa binh. gom: (i) Sff tin cgy; (ii) Sff ddp ffng; (iii) Su cdm thdng; (iv) Ndng luc phiic vu; (v) Phuang lien hffu hinh.
Tii khda: su hdi long, chdt lugng dich v«, Binh viin da khoa Phd Ndi. llnh Hung Yin Sumary
The article aims to discover determinants of people's satlifaction with the quality of medical examination and treatment services al Pho Noi General Hospital, Hung Yen province. The outcome points out five influential factors, which are (i) Reliability, (ii) Responsiveness; (iii) Empathy; (iv) Competence; (v) Tangibles.
Keywords: satisfaction, service quality. Pho Nbl General Hospital. Hung Yen province Giai THIEU
Chat Iffdng dich vu tai cdc benh vien cdng hien nay anh hffdng rd't ldn de'n sff hdi ldng cua ngffdi dan khi sff dung dich vu kham chffa benh. Benh vien da khoa Phd' Nd'i la bdnh vien tuye'n tinh cua tinh Hffng Yen, dffdc dat tai trung tam ciia thi xd My Hao, thu hiit Iffdng ldn ngffdi dan, cdc doanh nghiep tham gia khdm va dieu tri benh. Do dd, nang cao cha't Iffdng dich vu kham chffa benh se gdp phan tang doanh thu, cai thien ddi sd'ng cho can bd, nhan vien, dong thdi giam tai linh trang qua tai cho cdc benh vien tuyen Trung ffdng.
CO sd LY THUYET VA PHUONG PHAP NGHIEN CLfU
Crf sd ly thuyd't
Cha't Iffdng dich vu la mffc dp ma djch vu dap ffng dffdc nhu cau va mong mudn cua khach hang (Lewis va Mitchell, 1990; Wisnewski vd Donnelly. 1996).
Theo Parasuraman va cdng sff (1988). chd't Iffdng dich vu la khoang each giffa mong dpi cua ngffdi tieu
dung ve dich vu va nhan thffc cua hp ve ke't qua dich vu.
Oliver (1997) cho rang, giffa chat Iffdng dich vu va hai long khach hang ton tai sir khac biet nha't dinh, dffdc the hien d cac khia canh: cdc tieu chi do Iffdng, cdc danh gia, nhan thffc.
Trong dd, md hinh SERVQUAL dffdc phdt trien bdi Pasasuraman va cdng sff (1985) do Iffdng chat Iffdng dich vu dffa tren sff ky vong va cam nhan cua khach hang sff dung dich vu. Trong nghien cffu nay, 5 nhan to' danh gia chat Iffdng djch vu kham chffa benh, bao g6m: (1) Tin cay phan dnh kha nang thffc hien djch vu phu hdp va dung thdi han ngay tff Ian dau tien so vdi ky vpng cua ngffdi benh; (2) Ddp ffng phan anh mong mud'n sdn sang phuc vu Clia nhan vien y te, sdn sang cung cap djch vu cho ngffdi benh so vdi ky vong Clia ngffdi benh; (3) Cam thdng phan anh kha nang hieu bie't nhu cau cua ngffdi
"ThS., " T h S . , Tru'dng Dai hoc SLT pham ky thuat Hung Yen N'id\ nhdn bdi: OS/6/2020; Ngdy phdn bien: 16/6/2020: Ngdy duyet ddng: 25/6/2020
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bdnh thdng qua vide tim hieu nhffng ddi hoi cua hp, quan tdm de'n ca nhdn, giup dd chia se hp so vdi ky vpng ciia ngffdi benh;
(4) Ndng lffc phuc vu phan anh tnnh dd chuySn mon de thffc hidn dich vu, kha nang phuc vu bieu hien khi nhan vien tiep xiic vdi ngffdi benh, nhdn vien trffc ti^'p thffc hi^n dich vu, kha nang nghien cuH de ndm bat thdng tin lidn quan can thiet cho vide phuc vu ngffdi benh so vdi ky vpng cua ngffdi benh; (5) Phffdng tien hifu hinh the hien qua bieu hien ngoai hinh, trang phuc cua nhan vien phuc vu, cdc trang thie't bi phuc vu cho dich vu so vdi ky vpng ciia benh vien.
Mo hinh va gia thuyd't nghidn cffu De do Iffdng mffc dp hai ldng ciia ngu'di dan v^ chat Iffdng dich vu kham chiTa bdnh tai Benh vidn da khoa Phd' No'i, tdc gia ke' thffa va sff dung md hinh SERVQUAL gom cac nhdn to': sff tin cay, sff dap ffng, sff cam thdng, ndng lU'c phuc vu, phffdng tien hffu hinh. Ca 5 nhan to' ndy deu anh hffdng de'n sff hai long Clia ngffdi dan khi sff dung dich vu kham chiJa benh (Hinh).
Tff md hinh nghien cffu, nhdm tac gia de xua't cdc gia thuye't nghien cffu sau:
Gid thuyi't HI: Sff tin cay tdc dpng dffdng dd'n sff hdi long ciia bdnh nhan vdi cha't Iffdng dich vu khdm chffa bdnh.
Gid thuye't H2: Sff dap ffng tac ddng du'dng de'n sff hai ldng cua benh nhan vdi cha't Iffdng dich vu kham chffa benh.
Gid thuye't H3: Sffcam thdng tdc ddng dffdng dd'n sff hai ldng ciia bdnh nhan vdi chd't Iffdng dich vu kham chffa bdnh.
Gid thuyet H4: Nang lffc phuc vu tac dpng dffdng dd'n sff hai long cua bdnh nhan vdi chd't Iffdng dich vu khdm chffa benh.
Gid thuye't H5: Phffdng tidn hffu hinh tac i36ng dffdng dd'n sff hai long ciia bdnh nhan vdi cha't Iffdng dich vu khdm chffa benh.
Phffdng phap nghien cihi Nghien cffu kd't hpp giffa nghidn cffu dinh tinh va nghien cffu dinh lffdng.
Nghien cffu dinh tinh dffdc thffc hidn th6ng qua phdng van 20 benh nhan dang di^^u ffi tai Benh vidn da khoa Phd' Nd'i dd dieu chinh cdc bid'n quan sdt dung de danh gid mffc dp hai long ve cha't Iffdng dich vu khdm chffa benh tai Benh vidn.
Nghien cffu dinh Iffdng dffdc thffc hien thdng qua phdt phid'u khao sdt 450 ngffdi dan dang thffc hien kham chffa bdnh tai Bdnh vien trong thdi gian tff thang 01/2020 de'n thdng 3/2020. Kd't qua khao sat dffdc diing de phdn tich thdng qua sff
HINH: MO HINH NGHIEN CffU
S\i cam thong (H3) Nang l\tc phuc vy {H4) Phircmg lien hiiu hinh (H5)
Nguon De vuat cua nhom tac f^is BANG 1: KET QOA KIEM DjNH THANG DO BIEN DQC LAP
Bi^Q quan sat
1. Anh/chi tin tifdng vao ke't qua chan doan va phu'dng phap dieu tn tai benh vien
2 Nhan vien benh vien co g5ng khong de xay ra sai sdt khi thiTc hien dieu tri cho benh nhan
3, Chat lifcfng kham chiJa benh difOc dam bao diing nhif ihong bao cua benh vien
4 Hoat dong kham chu'a benh difOc thu'c hien mot each chinh xac 5. Nhan vien benh vien hila thu'c hien viec gi, thl ho se ihifc hien dung nhif vav
6 Cac V, biic SV luBn dap iJng difOc yeu cau cua ngiftfi benh 7. Nh3n vien y te thong bao chinh xic thdi gian cue dich vu se thifc hien
8. Cac y, bac sy benh vien luon san long giiip dci ngifcfi benb 9. Cac dich vu luon du'dc dap ii'ng day dii va kip thdi 10. Benh nhan de d&ns gap du'dc bSc sT ciia minh khi co yen can 11. Cae V. bac sy bi6't cham soc y t^'tdi tifng ngifdi benh 12. Cac y, bac sy luon hieu dUdc nhu'ng lo ISng, nhu cau dac bJet cua ngifdi benh
[3. Thdi gian thu'c hien khiim chBa benh thuan tien doi vdi ngu'di benh 14 Cdch cif xii" Clia bdc sy tao mem tin cho ngu'di benh 15. Anh/chi cam tha'y an loan khi ihifc hien kham chifa benh 16 Tai benh vien luon co y, bac sy gioi
17. Nhan vien nhiet tinh, vui ve hda nha 18 Do'i xiJ cong bang vdi benh nhSn 19. San sang gnip dd benh nhan 20. Benh vien ludn du'dc ve sinh sach se 21. Cac khoa, phong thoang mat, day du 22. Trang phuc cua nhan vien gon gang, hch stf 23. Dil giifdng cho benh nhan
24. Dii ghe ngdi chd
25 Cac trang thid't bi kham, chffa benh cua benh vien hien dai 26 Cung ling d^y du dien nu'dc
TiftfOg
.412 .377 391 .503 317 .505 ,305 .395 .502 .398 .509 .400 364 37!
.425 .450 .397 35!
.362 422 .430 378 .341 516 353 396
A^ifaa ii£alo8i
.841 .854 853 846 852 846 853 853 846 853 846 850 851 851 849 848 850 851 851 849 849 851 852 .846 ,851 .850
hd trd cua phan mem SPSS 20.0 (Bdi vii'l sff dung cdch vii't sd thap phdn theo chudn qud'c te).
KET QUA NGHIEN CLftJ Kiem dinh dO tin cay cua thang do
Bang 1 cho thd'y, 26 bid'n quan sdt anh hffdng de'n mffc dp hdi long cua benh nhan. cd he so'Cronbach's Alpha = 0.855 va cd he so' tffdng quan bie'n tdng Idn hdn 0.3, nen cac bie'n deu thda mdn yeu cau.
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BANG 2: KET Q U A KIEM DjNH THANG DO BIEN D O C LAP Bl£ii (man sdt
Hai long vdl each phuc vu ciia benh vien Hai long vdi cd sol vat chat ciia benh vien Hai long vdi chat lu'dng khim benh cua benh vien Hai long vdi chat lu'dng phuc vu cua benh vien Cronbach's Alpha
T i M n e a D ^ .753 .678 553 570 0.753
ia^^ss^.
.664 .703 .756 ,699
BANG 3: KET Q U A PHAN TJCH NHAN TO K H A M P H A CUA BIEN DpC L^P KMO and Bartlett's Test , v -.
Kaiser-Meyer-Olkin Measure of Sampling Adequacy | 734 Bartlett's Test of Sphericity
Approx Chi-Squarc j 17356,191 Df 1 325 Sig. 1 .000 l^f Ma tr$n h$ so xoay
Ket qua Cham sdc benh nhan Dap ffng yeu cau Y, bac sy gioi Thoang mat, day du Dien nu'dc day dii Trang phuc gon gang Nhiet tinh, vui ve Hieu du'dc ngffdi benh Khdng xay ra sai sdt Kip thdi Thdi gian thuan tien Dii giffdng benh nhan Doi xuf cdng bing Chat Iffdng dam bao San long giup dd Tbffc hien diing De dang gap bac sy Trang thiet bi hien dai An toan khi kham benh Benh vien sach se Chinh xac Dap ffng day du Dii ghe ngoi chd Cff xff cua bac sy Sfn sang giupdd
Component 1
921 919 912 871 867 .745
2
.957 ,950 .939 .783 .752
3
948 .938 932 .813 ,809
4
,939 ,920 .907 .801 800
t>
.916 .899 .876
6
826 ,821
7
BANG 4: KET Q U A PHAN TICH NHAN TO CUA BIEN PHG THUOC BifTn quan sat
Cd sd vat cha't Chat Iffdng phuc vu Cha'l Iffdng kham benb Cach phuc vu Eigen value
% of variance KMO
HI sd'tai nhSn tS*
.927 .924 934 843 2 362 85.203
.701
Ke't qua kiem dinh do tin cay thang do d Bang 2 cho tha'y, bid'n phu thuoc la sff hai Idng cua ngi/di dan ve chat Iffdng dich vu khdm chffa benh tai Bdnh vidn da khoa Phd' Nd'i dffdc do bang 4 bid'n quan sdt, cd he so Cronbach's Alpha la 0.753 va he so tffdng quan bien tong deu ldn hdn
0.3, nen dat yeu cau va dffa vao phan tich nhdn to ti^p theo.
Ke't qua phSn tich nhSa td' kham pha (EFA)
Bang 3 cho thay, he so' KMO la 0.734 (0.5 < KMO < 1). Dong thdi, ke't qua kiem dinh Bartlett's vdi mffc y nghia Sig. la ci.OOO nhd hdn 0.05, cac bid'n quan sat trong tong the cd md'i tffdng quan vdi nhau va chffng td dff lieu diing de phan tich nhan to' la hoan toan thich hdp.
Phan tich EFA cua bie'n phu thuoc vdl phffdng sai trich nhan to' Principal compoment, phep quay Varimax trich dffdc mdt nhdn to' vdi 4 bie'n quan sat va phffdng sai trich tich luy dffdc 85.203%
(> 50%), dat yeu cau (Bang 4).
Kid^m dinh md hinh va cac gia thuye't nghidn ciJU
Bang 5 cho tha'y, R' hieu chinh bang .574, nghTa la 57.4% sif bie'n thidn cua hailong (Sff hai ldng cua ngffdi bdnh) dffdc giai thich bdi sff bie'n thien cua 5 bid'n doc lap (HiTu hinh; Sff tin cay; Kha nang dap ffng; Nang lffc phuc vu; Sff cam thdng). Ngodi ra, kiem dinh Durbin - Watson d = 1.772 (1 < d < 3), khdng cd tffdng quan giffa cdc phan dff.
Bang 6 cho tha'y, tri so F cd mffc ^ nghia Sig,= 0.000 (< 0.05) md hinh hoi quy tuye'n tinh dffa ra la phil hop vdi dff lieu thu thdp dffdc va cac bid'n deu cd y nghia trong thong kd.
Tff Bang 7. md hinh hoi quy cd dang nhff sau:
Y = 0.179 X,+ 0.346X^ -\-0.557 X^ + 0.353X^+0.408X^+1.617
Kd't qua Bang 7 cung cho tha'y, cac he so' deu Idn hdn 0, nen cd the khdng dinh rdng md'i quan he giffa Sff hai ldng vdi chat ll/dng dich vu kham chffa benh cua ngffdi benh cd md'i quan hd cung chieu vdi cac nhan to'dffa ra phan tich. Do dd, cac gia thuyd't dffa ra deu phii hdp vdi mo hinh phan tich.
KET LUAN VA MQT SO DE XUAT Ket qua nghien cffu cho tha'y, cd 5 nhan td'tac dong de'n sff hai long ciia ngffdi benh ddi vdi chat Iffdng dich vu khdm chffa bdnh tai Benh vidn da khoa Phd' Nd'i. tinh Hffng Yen, dd la: Sff tin cay; Su" dap ffng;
Sffcam thdng; Nang lffc phuc vu; Phffdng tien hihi hinh. Trong dd. nhan to' Sff cam thdng cd anh hu'dng manh nhat; con nhan to' Sff tin cay cd tac ddng it nha't de'n sff hdi long cua ngffdi benh dd'i vdi chat Iffdng
186
djch vu khdm chffa bdnh tai Bdnh vidn da khoa Phd' Nd'i, tinh Hffng Ydn.
Dffa trdn ke't qua nghidn cihi, nhdm tdc gia cd mot so' de xua't sau:
Bdi vdi nhdn to'HOu hinh B6nh vidn can tang cffdng d^u tff cd sfl vdt cha't, trang thid't bi hidn dai phuc vu cdng tac khdm chffa bdnh cho ngffdi ddn khu vffc thj xa My Hao va cdc huydn ldn can.
Benh vien can dau tff, nang cap cac phan qudn ly, dac bidt ke't ndi dffdc dff lidu ffong he thd'ng cd quan bao hiem xa hdi, giffa cd quan bao hie'm xa hdi vdi cd scl khdm chffa bdnh bang bao hiem y te'.
Boi vdi nhdn to'Sff tin cgy Bdnh vidn can xdy dffng quy trinh khdm chffa benh chuan, dat tai khu vffc khdm chffa bdnh giiip ngffdi dan cd the quan sdt va doc dffdc cac thdng tin.
Nang cao trinh do chuyen mon cua doi ngu bdc sy trong viec chan dodn va di^u tri cho benh nhan, giup ngffdi benh tin tffdng vao kd't qua kham chffa benh trdnh tinh trang phai vffdt tuyen, giam tdi cho cdc benh vidn tuye'n tren.
Bdi vM nhdn td'Stf ddp ting Dpi ngu can bd, nhan vidn cua Benh vien c^n cdi md, than thidn vdi ngffdi bdnh, ludn san long ddp ffng va giiip dd hg ffong liic khd khan va benh tat vdi tam long "Lffdng y nhff tff mdu".
Ddi vdi nhdn to'Sff cdm thdng Bdnh vidn c^n xay dffng mdi trffdng lam vide cdi md, kich thich sff nang ddng, phat huy hidu qua cua can bo nhdn vien.
Ben canh vide can xdy dffng hd thdng tidu chi danh gia can bp, nhdn vien, dpi ngu y, bdc sy phu hdp, trong do cd tidu chi stf cam thdng vdi ngffdi bdnh; Bdnh vien la'y y kie'n ddnh gid cua ngffdi bdnh ve ddi ngu y, bac sy lam cd sd de xay difng mdi trffdng lam viec than thien,
"LiTdng y nhff tff mdu ".
BANG 5: MCfC DO GIAI THICH CUA MO HINH Model Summary^
Md R 1 1 ,812'
R binh phUdng
659
R binh pbifcfng bi^u chinh
.574
Sai sd'chuan Durbin- ciia iftfc Itf^g Watson
.46894 1.772 a, Bien doc lap: (Constant), Huu hinh, Dap ung. Cam thoiiE, Nan); lue phuc vu. Tin cay b, Bien phu thuoc: Hai long
BANG 6: PHAN TICH ANOVA Md hinh I T^ng binh phtfriap iS I Binh phtfrfng tnme binh
Hoi guy
71.250 324 II8.550I 329
,220 ... Bie'n phu thuoc Hai long
b. Bien doc 15p: (H^ng sd). Huu hinh. Dap ung. Cam thong. Nang li
9.460 43.017 ,000' Jifi.
BAMG 7 Mdhinh
'
(Hans so) Tin cav Dap unp Cam thons Nang Iuc phuc vu Huu hmh
: THOMG KE PHAN TICH CAC HE SO HOI QUY H^sffhSiquycbi^
chu^n boa
P
1.617 .179 ,346 ,557 ,353 ,408
Sai s^ctau^n -257 .275 .268 .081 ,108 105
Hg sfi'hSi quy chu^n hoa
Beta ,058
251 .414 ,194 ,330
t 5,895
,289 1,292 5,662 2,336 3,882
Sig.
,000 ,043 ,037 .000 010 ,()0(>
Thdng M da cdnc tuvS'n Dung sai
.046 049 346 ,269 .257
VIF 21 966 20,409
2 887 3,717 3.898 a. Bien phu thuoc Hai long
Bdi vdi nhdn td'Ndng lffc phuc VH
Benh vidn can dao tao dpi ngii ddn tid'p bdnh nhdn an can, than thien, cd tinh than phuc vu khach hang td't.
Bie't each hd trd bdnh nhan giam bdt sff cdn^ thang, cho dii cd sd khdm benh dang trong thdi diem ddng due, ban rdn nha't.
Can cd sit ddi xff cdng bang giffa benh nhan ngffdi nha cua can bo nhan vidn trong Benh vien va ngffdi dan khi vao khdm chffa bdnh.
Ngoai ra, bdnh nhdn thffdng cd nhu cau dffdc kham sdm, thay vi chd ddi, xd'p hang, Bdnh vien ndn cd dich vu kham chffa benh theo yeu cau de dap ffng cho tffng nhdm bdnh nhan. Bdnh nhan ludn mud'n dffdc bac sy tff vd'n chu dao thay vi qua loa va nhdn dffdc phffdng an dieu trj hidu qua cho tinh trang benh tdt cua minh.U
TAI LIEU THAM KHAO
1. Lewis, B. R. and Vincent W. Mitchell, V. W. (1990). Defining and Measuring the Quality of Customer Service. Markedng Intelligence & Planning
2. Oliver, R. L (1997). A Behavioral Perspective on the Consumer. The McGraw-Hill Companies, Inc., New York
3. Parasuraman, A., ZeithamI, V. A., and Berry, L. L. (1985). A Concepmal Model of Service Quality and Its Implications for Future Research, Journal ofMakeiing. 49. 41-50
4. Parasuraman, A., ZeithamI, V. A., and Berry, L. L. (1988). SERVQUAL: A Multiple-Item Scale for Measuring Consumer Perceptions of Service Quality, Journal ofReiailing, 64( 1). 12-40 5. Wisniewski, M.. and Donnelly, M (1996). Measuring service quality in the public sector: the potential for SERVQUAL, Management Science. 7(4). 357-366
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