Research on The Impact of Medical Service Quality on Patient Trust : Mediating Effect Analysis Based on Patient SatisfactionDan Liu = 의료서비스 품질이 환자 신뢰도에 미치는 영향에 관한 연구 - 환자의 만족도를 매개변수

다국어 초록 (Multilingual Abstract)

In recent years, the level of medical services in China has continuously improved, and the medical service system has been gradually improved. However, research shows that there prominent contradictions and conflicts between doctor and patient. According to the number of medical conflicts cases accepted by Chinese courts, there were 12,734 cases of medical damage liability conflicts in 2017, 12,249 cases in 2018, 18,112 cases in 2019, and 18,670 cases in 2020. At the same time, data from the 2017 "White Paper on the Practice Status of Chinese Physicians" shows that 66% of physicians have experienced varying degrees of doctor-patient conflicts. It can be seen that the current level of harmony in doctor-patient relationships in China is relatively low. In previous literature studies, the reasons for the deterioration of doctor-patient relationships were mostly attributed to macro-level deficiencies. However, after undergoing the latest round of healthcare system reforms, the country has strengthened healthcare financial investment, implemented a hierarchical medical system, and reformed the payment methods of medical insurance. In recent years, more scholars have focused their research on the micro-level individual aspect of doctor-patient relationships, namely the fundamental trust relationship between doctors and patients. The conclusions drawn from previous research findings have shown that the impact of medical service quality and patient satisfaction on patient trust has received extensive attention in the academic community. However, existing studies have only focused on the separate effects of medical service quality and patient satisfaction on patient trust, while neglecting the relationship among these three factors. Building upon previous research, this study employs literature review, questionnaire survey, and statistical analysis methods to investigate. By constructing relevant theoretical models, descriptive statistical analysis, reliability analysis, factor analysis, correlation analysis, and regression analysis are conducted using SPSS 26.0 to analyze and validate the research hypotheses and models. Additionally, the study utilizes AMOS 22.0 software to conduct a modified research on the structural equation model derived from the analysis. The aim of this study is to investigate the underlying mechanisms between medical service quality and patient trust, as well as the mediating effect of patient satisfaction. Finally, based on the findings, relevant recommendations and strategies are proposed to enhance patient trust. This study reviews and summarizes relevant literature on patient trust, patient satisfaction, and medical service quality management in China and other countries. Based on the SERVQUAL service quality measurement method and considering the specific characteristics of the healthcare industry, the study modifies the SERVQUAL scale through literature research. Additional dimensions such as perceived technical quality assessment are added on top of the existing five dimensions, along with validity and cost considerations, to expand the application of the SERVQUAL scale in the healthcare industry. The study finds significant differences in the perception of medical service quality among patients based on demographic variables such as patient age, education level, occupation, family income, and location. There are also significant differences in patient satisfaction evaluations based on the monthly family income level and reasons for seeking treatment at different hospitals. Differences in patient trust evaluations are found based on whether it is the patient's first visit to the hospital and the reasons for seeking treatment at different hospitals. Regarding the relationship among medical service quality, patient satisfaction, and patient trust, the study reveals that various dimensions of medical service quality have a positive and significant impact on patient satisfaction. Some dimensions of medical service quality also have a positive and significant impact on patient trust, except for responsiveness, which does not significantly affect patient trust. Patient satisfaction has a positive and significant impact on patient trust, and patient satisfaction serves as a significant mediator between service quality and patient trust. Based on the research results, the article puts forward relevant countermeasures and suggestions. In view of the differences in demographic and sociological statistical variables in various dimensions, it is necessary to identify key characteristics and provide personalized services; Regarding the impact of medical service quality on patient satisfaction and trust, we should understand patient expectations, improve service levels, improve medical technology, and control medical prices; In view of the mediating role of patient satisfaction, it is necessary to pay attention to patient satisfaction and cultivate patient trust. Key Words: Patient Trust; Medical Service Quality; Patient Satisfaction; SERVQUAL Scale Student Number：20218172

목차 (Table of Contents)

• I. Introduction 1
• 1. Research Background and Significance 1
• 2. Research Purpose and Research Content 6
• 3. Research Methods and Innovation Points 12
• Ⅱ. Literature Review and Theoretical Basis 14
• 1. Literature Review 14
• 2. Related Concepts 32
• 3. Theoretical Basis 43
• Ⅲ. Research design 53
• 1. Model Construction 53
• 2. Research Hypothesis 54
• 3. Scale Design 63
• 4. Research Scheme 68
• 5. Questionnaire Pre-Test 72
• Ⅳ. Empirical Analysis 79
• 1. Demographic Information of the Sample Population 80
• 2. Current Status of Medical Service Quality, Patient Satisfaction
• and Patient Trust 82
• 3. Reliability and Validity Test 85
• 4. Difference Analysis of Different Characteristic Populations 91
• 5. Correlation Analysis of Medical Service Quality, Satisfaction and
• Trust 102
• 6. Regression Analysis of Medical Service Quality, Satisfaction and
• Trust 104
• 7. Path Analysis of The Impact of Medical Service Quality and
• Patient Satisfaction on Patient Trust 112
• 8. Research Hypothesis Verification Results 118
• 9. Discuss 120
• Ⅴ. Conclusion and Outlook 137
• 1. Research Conclusion 137
• 2. Management Inspiration 138
• 3. Research Limitations and Outlook 142
• References 145
• Appendix 159
• 한글초록 166
• Ethical Statement 168
• Acknowledgenments 169