Nghiên cứu sự hài lòng của bệnh nhân về chất lượng dịch vụ y tế nội trú tại các bệnh viện trung ương tp.Hồ Chí Minh











NGHIÊN C S HÀI LÒNG CA BNH NHÂN
V DCH V Y T NI TRÚ
T CÁC BNH VI
TP.H CHÍ MINH




Chuyên ngành :
 ngành:60340102


11 2013









NGHIÊN C S HÀI LÒNG CA BNH NHÂN
V CH V Y T NI TRÚ
T CÁC BNH VI
TP.H CHÍ MINH




Chuyên ngành :
 60340102








11 






 







HCM ngày tháng  2013




TT


1
TS. L

2


3
c


4


5




        





HCM
PHÒNG QLKH - 
HOÀ 
- - 

 03 13




Chuyên ngành: MSHV:
I- 

II- 





III- 
IV- 
V- 


 
 





04/05/1985
Nam
TP.HCM

1184011077



-    

-   


- 
29/06/2012
31/10/2013

v



L

 

nào khác. 
Xuân Giang.









vi


L

 
- Quý Thi hc Công Ngh Tp.H t lòng truyn
t nhng kin thc quý báu trong sut thi gian hc tc bit là Tin
 ng dn tn tình v c và ni
 tài.
- Anh Tài  K ng BV Ch Rng dn và gii thiu tôi
n các bnh vi Chí Minh tìm hiu, nghiên cu thông tin
v dch v khám cha bnh ni trú và u tra mt phn d lip ti bnh
vin.
- c và các anh ch trong BV Ch Ri h
Hàm M, BV Nhân dân Thng Nhtng, BV
Chnh Hình, BV Mt TP.HCM, BV Bnh Nhii o mi
u kin thun li cho tôi trong sut quá trình 
tài.
- Cun bè và các bn hc viên lp
i hc Qun Tr Kinh Doanh  ng viên, h tr tôi trong
sut quá trình hc tp và thc hin  tài.
Trong quá 





vii


TÓM TT

ng cao, nhu
 
 và 
hàng.
   



- c mt da vào lý thuyt cng vnh tính
  tài.
- c hai dùng phng vng thông qua vic thu thp thông tin bng
bng câu hi vi khách hàng ca các bnh vin ti Tp. H Chí Minh. Sn
hành phân tích nhân t  chn ra nhng nhân t mi. Dùng
kinh Cronbach ki tin cy ca thang  sau cùng
chy phân tích hn  thy mi ràng buc gia các nhân t vi s hài
lòng ca khách hàng ti Tp.H Chí Minh.

5   



viii


onbach

phù 
n hu hình
X2:M ng cm
X3:Mng tin cy
c phc v
X5:Kh ng
-h


 
nhóm khách hà 


 








ix


ABSTRACT

Currently, the trend of social development and the population increases so the
demand for medical services is a matter of business and be top concern worldwide.
Therefore nowadays healthcare services always require change and continuous

improvement to meet every customer.
The purpose of this thesis is to search the factors which impact on customer
satisfaction with inpatient medical services to provide solutions specifically to enhance
the quality of inpatient medical services at the hospital central in Ho Chi Minh City.
Thesis was conducted in two following steps:
- Step one based on the theory of SERVQUAL scale and interviews to provide
qualitative models for thesis research.
- Step two used qualitative interviews through the collection of information
using the questionnaire to customers of the hospitals in Ho Chi Minh City.
Then proceed to explore factor analysis(EFA) to select the new factors. Using
Cronbach's Alpha testing to verify there liability of the scale and finally run
amultivariate regression analysis to show the bond between the factors of
customer satisfaction in Ho Chi Minh City.
This thesis combined 5 measures constructive service quality measurement scale
with 25 observed variables associated with quantitative research to evaluate the most
component that influenced the level of customer satisfaction use in inpatient services.

x


Through the Cronbach's Alpha testing, we conclude scale construction that is
appropriate. EFA factor research we extracted 5 main factors in the following order:
X1: Tangibles
X2: Empathy
X3: Reliability
X4: Assurance
X5: Responsiveness
The results of T-test and ANOVA to examine the effects of qualitative variables
(occupation, age, education, gender, number of days of hospitalization, number of
hospitalizations, etc.) to quantify the variables of the model (customer satisfactionlevel).

On the basis of the results found through this thesis can be examined with more
diverse group of customers, number of samples larger, wider field or research. Also
qualitative research design further under the advice of experts in the martket to ensure the
highest practical applications.
Due to limited knowledge and lack of practical experience, so my essay inevitable
shortcomings. Look forward to the contribution information, valuable feedback from
teacher, and reader.





xi


MC LC
L v
L vi
TÓM TT vii
ABSTRACT ix
MC LC xi
DANH MC CÁC T VIT TT xv
DANH MC CÁC BNG xvi
DANH MC CÁC HÌNH NH, BI xvii
LI M U 1
1.1.  1
1.2.  1
1.3.  2
 LÝ LUN V DCH V Y T NG
DCH V Y T 3

2.1.  3
2.1.1. nh vin 3
2.1.2. Phân loi bnh vin 3
2.1.2.1. Da theo t chc hc 3
2.1.2.2. Da theo thành phn kinh t 3
2.2.  4
2.3. -  5
2.3.1. Khái nim dch v 5
2.3.2. Khái nim dch v y t: 6
2.3.3. m ca dch v 6
2.4. -  7
2.4.1. Chng dch v 7
2.4.2.  8
2.5.  8
2.5.1. Khái nim s hài lòng ca khách hàng 8
xii


2.5.2. Mng s hài lòng 8
2.5.3. Phân loi s hài lòng ca khách hàng 9
2.6.  9
2.7.  11
2.7.1. ng ca giá c n s hài lòng ca khách hàng 11
2.7.2. Quan h ging giá c, giá tr và giá c cm nhn 11
2.7.3. Mi quan h gia s hài lòng khách hàng và hình nh doanh nghip 11
2.8.  12
2.8.1.  12
2.8.2.  13
2.8.3. Mô hình 4P 14
2.8.4. Mô hình chng dch v SERVQUAL 14

2.8.5. Các mô hình trong QLCL y t 16
2.9.  17
N TRNG V CHNG DCH V Y T TI
TP.H CHÍ MINH 18
3.1.  18
3.1.1. Quá ti bnh vi 18
3.1.2. NGUYÊN NHÂN CHÍNH DN TI QUÁ TI BNH VIN 19
3.1.2.1.  h tng vi nhu cu và t phát trin dân s 19
3.1.2.2. c v công tác khám cha bnh tuyi còn nhiu hn ch 19
3.1.2.3.  19
3.1.2.4. ng bnh tt và nhu cu khám cha bnh 20
3.1.2.5. Tâm lý la chn dch v khám cha bnh ci dân 20
3.2. 
MINH 21
3.2.1. Ngun nhân lc: 21
3.2.2. Tình hình chi ngân sách ngành y t: 22
xiii


3.2.3. Hong khám cha bnh ni trú ti thành ph H Chí Minh: 23
3.2.4. Quá ti bnh vin tuyn cui thành ph H Chí Minh: 24
3.3.  25
3.3.1. ng dch v y t c 25
3.3.2. ng dch v y t th gii 25
3.4.  26
3.4.1. V h tng k thut 26
3.4.2. H tng nhân lc công ngh thông tin 26
3.4.3. ng dng CNTT 26
3.4.4. Ngân sách cho CNTT 27
 HÀI LÒNG CA BNH NHÂN KHÁM CHA BNH

NI TRÚ 28
4.1.  28
4.1.1.  28
4.1.2.  29
4.2.  29
4.2.1.  29
4.2.1.1.  30
4.2.1.2.  30
4.2.2.  31
4.2.2.1.  31
4.2.2.2.  32
4.2.3.  33
4.2.3.1.  33
4.2.3.2.  34
4.2.4.  35
4.2.5.  42
4.2.5.1.  42
4.2.5.2.  khám phá (EFA) 48
4.2.5.3.  48
xiv


4.2.5.4.  51
4.2.5.5.  56
4.2.5.6.  70
5: MT S GII PHÁP NÂNG CAO CHNG DCH V KHÁM
CHA BNH NI TRÚ TI CÁC BNH VI 76
5.1.  76
5.1.1.  76
5.1.2.  77

5.2. 
TP.HCM 77
5.2.1.  78
5.2.2.  79
5.2.3.  82
5.2.4.  84
5.2.4.1.  85
5.2.4.2.  án 86
5.2.4.3.  87
5.2.4.4.  88
5.2.4.5.  89
5.2.5. Gi 93
5.2.6.  94
5.2.7.  95
5.3.  96
5.3.1.  96
5.3.2.  97
TÀI LIU THAM KHO 98
PH LC 99

xv


DANH MC CÁC T VIT TT

Tp. HCM 
BN 
BV 
SERVQUAL 
KCB 

KB 
CB 
CSSK 
TTB 
QLCL 
CBVC 
YTCC 
CNTT 
THCN 

xvi


DANH MC CÁC BNG
  8  2012 20
Bàng 3.2 : Tình hình chi ngân 8-2012 21
  -
2012) 22
  23
.1  31
  33
  34
  35
  36
  37
  38
  39
  40
  42
  43

  44
  45
  46
.15  47
.16 : KMO and Bartlett 48
.17 :  48
4.18  50
4.19  52
4.20 : ANOVA 53
4.21 : Cofficients 54
dent  sample T  test) 56
Bàng 4.23 - 58
  - 59
  61
 - 64
 - 65
28 : - 66
 -way ANOVA theo  68
  70
  71
   72
  73
4.34  74
 
CNTT 90
xvii


DANH MC CÁC HÌNH NH, BI
  10

  12
  12
Hình 2.4  15
Hình 2.5   15
Hình 3.1 : Tình hình chi ngân sách 8-2012 22
Hình 3.2 : 8-
2012) 22
Hinh 3.3 :  23
Hình 3.4 : Ngân sách trung  - 
 26
Hình 4.2 : Mô hình nghiên  27
4.1 : 28
Hình 4.3   34
Hình 4.4  35
Hình 4.5  36
Hình 4.6  37
Hình 4.7  38
Hình 4.8  39
Hình 4.9  40
Hình 5.1  78
Hình 5.2  78
Hình 5.3  82
Hình 5.4  83
Hình 5.5   85
Hình 5.6  86
Hình 5.7  87
Hình 5.8  88
Hình 5.9 -Quang 88
Hình 5.10  89
Hình 5.11  89

Hình 5.12  91

1


LI M U
1.1. Lý do ch tài










 c 
 
.
     

                
TP.HCM.
1.2. Mc tiêu c tài
  
      
 
KCB 
   n


2


    
 
  
hài lòng 
 TP.HCM.

         
 
1.3. Phu

          .   
khám
 
 
.

tính là 1.000  1.500 
               
SPSS 16.0.

3


2 LÝ LUN V DCH V Y T
NG DCH V Y T
2.1. Tng quan v bnh vin

2.1.1. nh vin

  
 


2.1.2. Phân loi bnh vin
2.1.2.1. Da theo t chc
- BV thuc tuyn y t 
- BV thuc tuyn y t m
 BV thuc tuyn y t tnh, thành ph
 BV thuc tuyn y t qun, huyn, th xã
 BV thuc tuyn y t ng hc
2.1.2.2. Da theo thành phn kinh t
- BV c
- BV 

4


2.2. Khái nim khách hàng, bnh nhân, khám cha bnh ni trú
Khách hàng 
.
Theo Wal-Mart, khách hàng  au:
 
  

           

 

 
 
 

 

  
 






 


              
 

5


2.3. Khái nim dch v - dch v y t
2.3.1. Khái nim dch v
Hin nay, có nhiu tranh lun v khái nim dch vt s khái nim:
 Philip Kotler 
  , 
 


 hàng hóa.

  

     

.
 

.
 



phm vô hình, 
   ng;           ;
, 
kho.

6


2.3.2. Khái nim dch v y t:

 

hàng 

hàng 
      

   


2.3.3. m ca dch v

   và tiêu dùng 

  
 
           

 Vô hình (Intangibility): 
khi tiêu dùng.
  


7


2.4. Chng dch v - chng dch v y t
2.4.1. Cht ng dch v






thích: 



Lewis và Booms ph


.


1. 
2. 
        

3. 
             
             



           



8


2.4.2.  y t


 

u





 





   


2.5. S hài lòng ca khách hàng
2.5.1. Khái nim s hài lòng ca khách hàng
               

.
2.5.2. Mng s hài lòng


