中央健康保險局服務滿意度之調查研究

Abstract

提昇服務品質為中央健保局重點工作目標之一，而「顧客滿意度」亦為健保局各分局績效衡量之評核項目，本研究旨在針對保險對象、投保單位及醫事服務機構三類健保局之服務對象進行調查，以評估其對健保局台北、北區、中區、南區、高屏及東區等六分局之顧客滿意度。

為達成上述目的，本研究首先參照服務品質之相關理論，並依據健保局對保險對象、投保單位及醫事服務機構提供之業務內容，分別構建三種調查問卷。繼而依據抽樣理論建立對三種不同調查對象之抽樣設計，並透過郵寄問卷及人員訪問進行調查。最後透過統計方法分析服務對象對各分局之顧客滿意度，及對各服務項目之滿意情形。

研究結果發現，健保局對一般民眾提供之各項服務中，應將申請加保等手續、申請及換發健保卡手續、諮詢服務、服務人員完成作業的效率及服務態度等服務項目列為優先加強之重點。而對於服務品質較不滿意之民眾通常具有高學歷、未婚、年齡層較低之自由業或民營公司員工等特徵，對此等服務對象宜加強；其次，在投保單位方面，應將電話諮詢管道之暢通、申訴及抱怨處理、服務人員完成作業之效率與保費計算正確等服務項目列為優先加強之重點；而對醫事服務機構而言，各項服務品質項目中，應將醫療費用申報及核付工作、業務諮詢服務、抱怨申訴服務及電話諮詢管道等服務項目列為優先加強之重點。對服務品質期望程度較高之醫事服務機構通常為區域醫院，健保局應加強對此類型醫事服務機構期望之服務要素加強服務，以提升服務品質滿意度。

本研究所設計之調查方法可供健保局建立服務滿意度調查之基本模式，調查結果亦可據以為評估各分局「顧客滿意度」項目之績效，及各分局改善服務品質之參考。

To upgrade service quality is one of the major work of Bureau of National Health Insurance (BNHI). In addition, customer satisfaction is also one of the evaluation item of business performance of each branch of the BNHI. This study attempts to investigate such three service objects as the insured party, insured sector and medical service sector of the BNHI, to evaluate their customer satisfaction level of such 6 branches of the BNHI at Taipei, northern area, central area, southern area, Kaohsiung-Pingtung and east area.

The study starts by reviewing the related theories of service quality, and according to the business content of Bureau of National Health Insurance to its insured party, insured sector and medical service sector, to design 3 kinds of questionnaire. Then, according to sampling theory, it sets up sampling design concerning the 3 kinds of different investigation parties, and through questionnaire mail and personnel interview to engage in investigation. At last, this study analyze the customer satisfaction of the service objects toward each branch, and the satisfaction level about each service item by statistical method.

To conclude, the investigation method designed for this study can serve to Bureau of National Health Insurance as a basic model to set up investigation of service satisfaction. The investigation result may also provides useful information for evaluating customer satisfaction as the business performance of each branch, and the reference of each branch in improving its service quality.