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研究生：	盧筱筠 Lu, Hsiao-Yun
論文名稱：	台灣醫療觀光之服務價值導向模式:風險態度及口碑之干擾效果 The Service Value Oriented Model of Medical Tourism in Taiwan: The Moderating Effects of Risk Attitude and Word-of-Mouth
指導教授：	吳萬益 Wu, Wann-Yih 陳淑惠 Chen, Shu-Hui
學位類別：	博士 Doctor
系所名稱：	管理學院 - 企業管理學系 Department of Business Administration
論文出版年：	2012
畢業學年度：	100
語文別：	英文
論文頁數：	273
中文關鍵詞：	醫療觀光、服務價值導向模式、風險態度、口碑、旅遊目的地形象
外文關鍵詞：	Medical Tourism, Service Value Oriented Model, Risk Attitude, Word-of-Mouth, Destination Image
相關次數：	點閱：161 下載：5
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醫療觀光為全球旅遊產品，現今對許多亞洲國家具有其經濟發展之重要性。作者希望透過本研究瞭解醫療觀光在台灣的發展，並且建構一個吸引外國人前往台灣與增加他們對醫療旅遊價值的行銷策略。此策略包含醫院層級與個人層級之觀點，亦包含對醫療旅遊之認知價值極具重要性的前置變數與結果變數。由於相關此議題的文獻非常有限，本研究首先從質性研究開始，藉由專家訪談方式確認各層級與各過程之重要因素。本研究前後總共訪談十四位專家，針對拓展台灣醫療觀光價值之角度，導出共二十四個命題。接著進行實證研究，以問卷調查之方式共收集醫院從業人員資料225份與醫療旅遊消費者資料154份，經量化統計分析得到以下結論。1.增加醫療觀光之認知價值極為重要的前置變數包括服務品質、醫院信譽與醫院形象。結果變數則包括醫療旅遊之態度、滿意度與購後行為意圖。2.影響醫療旅遊之認知價值最重要的因素為醫院服務品質與醫院形象。影響購後行為意圖最重要的因素為醫療旅遊之滿意度。3.個人影響對於前置變數跟醫療旅遊之認知價值的關係具有干擾的作用。尤其是個人的風險態度與自尊對於醫院服務品質、醫院信譽與醫院形象對醫療旅遊認知價值之關係有顯著之加乘效果。4.外在影響對於前置變數跟醫療旅遊之認知價值的關係具有干擾的作用。尤其是口碑與旅遊目的地形象對於醫院服務品質、醫院信譽與醫院形象對醫療旅遊認知價值之關係也有顯著之加乘效果。由於過去對於醫療觀光之研究仍屬探索性之階段，本研究所推導之研究架構及實證結論可做為後續研究之重要參考，也可作為旅行業者及醫療業者推動醫療觀光行銷及醫療觀光管理之重要依據。

Medical tourism is a product in the global tourism arena and it has become increasingly important in the developing countries of Asia. This study aims to explore the medical tourism development in Taiwan and to develop an applicable marketing strategy integrating the antecedents and consequences of perceived value toward medical travel from hospital level and individual level to attract more potential visitors. Since previous studies relevant to this research issue are limited, this study starts with a qualitative study by using expert interviews and ends up with two empirical studies to provide rigorous research results. The results of this work are as following. (1) Three antecedent variables from hospital level are identified. They are hospital service quality, hospital credibility and hospital image. Another three consequences from individual level are identified. They are attitude toward medical travel, satisfaction toward medical travel and post-purchase behavioral intention. (2) The most significant factors that influence perceived value toward medical travel are hospital service quality and hospital image. The most important factor that influences post-purchase behavioral intention is satisfaction toward medical travel. (3) The level of self influence will moderate the impacts of hospital elements on perceived value. Specifically, the level of consumer’s risk attitude and self esteem will significantly promote the influences of hospital service quality, credibility and image on perceived value toward medical travel. (4) The level of external influence will moderate the impact of hospital elements on perceived value. Specifically, the level of word-of-mouth and destination image will significantly promote the influences of hospital service quality, credibility and image on perceived value toward medical travel. As being exploratory in nature, the proposed model and the results in this study can be used for further validations. The study results may also provide very significant contributions to both the government and practitioners to further engage in medical tourism marketing and management.

ABSTRACT ……………………………………………………………I
TABLE OF CONTENTS…………………………………………………VI
LIST OF TABLES	……………………………………………………XI
LIST OF FIGURES	……………………………………………………XIV
CHAPTER ONE	INTRODUCTION……………………………………1
1	Research Background and Motivation…………………………1
2	Research Objectives………………………………………………4
3	Research Process…………………………………………………5
CHAPTER TWO	LITERATURE REVIEW……………………………7
1	Medical Tourism……………………………………………………7
1.1	Current Market Situation of Medical Tourism in Asia ………10
1.2	Medical Tourism Development in Taiwan……………………11
2	Hospital Level Medical Tourism Elements……………………13
2.1	Service Quality…………………………………………………15
2.2	Corporate Credibility……………………………………………16
2.3	Corporate Image…………………………………………………17
3	Individual Level Medical Tourism Elements………………………18
3.1	Perceived Value, Attitude and Satisfaction……………………19
3.2	Post-Purchase Behavioral Intention……………………………21
3.3	Risk Attitude………………………………………………………22
3.4	Self-Esteem…………………………………………………………24
3.5	Word-of-Mouth Sources……………………………………………25
3.6	Destination Image…………………………………………………26
CHAPTER THREE	RESEARCH DESIGN AND METHODOLOGY…27
1.	Research Model……………………………………………………27
2.	Stage One - The Qualitative Research…………………………28
2.1 	Research Design …………………………………………………28
2.2 	Sampling Information ……………………………………………30
2.3 	Content Analysis …………………………………………………31
2.4 	Reliability Test for Coding and Categories …………………32
3	Stage Two – The Quantitative Research………………………34
3.1 	Research Design and Sampling Information…………………34
3.2 	Construct Measurement…………………………………………35
3.3 	Quantitative Data Analysis………………………………………44
CHAPTER FOUR	QUALITATIVE STUDY RESULTS AND DISCUSSIONS…47
1	The Effect of Service Quality on Hospital        Credibility……………47
2	The Effect of Service Quality on Hospital Image………………49
3	The Effect of Hospital Credibility on Hospital Image……………50
4	The Effects on Perceived Value toward Medical Travel…………52
5	The Effects of Perceived Value toward Medical Travel…………53
6	The Effects among Attitude, Satisfaction and Post-Purchase Behavioral Intention…………………………………………………………………56
7	The Moderating Role of Risk Attitude……………………………58
8	The Moderating Role of Self-Esteem……………………………60
9	The Moderating Role of Word-of-Mouth Sources………………62
10    The Moderating Role of Destination Image……………………65
CHAPTER FIVE 	QUANTITATIVE STUDY RESULTS AND 
        DISCUSSIONS…………………………………………………………68
1	Descriptive Analysis………………………………………………68
1.1 	Sample and Data Collection……………………………………68
1.2	Characteristics of Respondents ………………………………69
1.3 	Measurement Results for Research Variables………………71
2	Exploratory Factor Analysis and Reliability Test………………75
2.1	Service Quality…………………………………………………76
2.2	Corporate Credibility……………………………………………77
2.3	Corporate Image …………………………………………………77
2.4	Perceived Value toward Medical Travel ………………………78
2.5	Attitude toward Medical Travel …………………………………79
2.6	Satisfaction toward Medical Travel ……………………………79
2.7	Behavioral Intention ………………………………………………80
2.8	Risk Attitude ………………………………………………………81
2.9	Self-Esteem ………………………………………………………81
2.10	Word-of-Mouth Sources…………………………………………82
2.11	Destination Image ………………………………………………82
3	Comparisons of Opinions between Hospital Staffs and International Tourists……………………………………………………………………83
4	Hypotheses Testing for Study 1: Hospital Staffs…………………85
4.1	The Effects of Service Quality and Hospital Credibility…………85
4.2	The Effects on Perceived Value toward Medical Travel…………86
4.3	The Effects of Perceived Value toward Medical Travel…………86
4.4	The Effects among Attitude, Satisfaction and Post-Purchase Behavioral Intention……………………………………………………………………87
4.5	The Moderating Role of Risk Taking Attitude……………………88
4.6	The Moderating Role of Self-Esteem……………………………91
4.7	The Moderating Role of Word-of-Mouth Sources………………94
4.8	The Moderating Role of Destination Image………………………97
5	Hypotheses Testing for Study 2: International Tourists…………99
5.1	The Effects of Service Quality and Hospital Credibility………100
5.2	The Effects on Perceived Value toward Medical Travel………100
5.3	The Effects of Perceived Value toward Medical Travel………101
5.4	The Effects among Attitude, Satisfaction and Post-Purchase Behavioral Intention……………………………………………………………………102
5.5	The Moderating Role of Risk Taking Attitude…………………102
5.6	The Moderating Role of Self-Esteem……………………………106
5.7	The Moderating Role of Word-of-Mouth Sources………………109
5.8	The Moderating Role of Destination Image……………………112
6	The Path Comparisons between Hospital Staffs and International Tourists……………………………………………………………………115
7	The Structural Equation Model……………………………………117
7.1	The Model of the Influences of Antecedent Factors on Perceived Value………………………………………………………………………118
7.2	The Model of the Influence of Perceived Value on the Consequences of Medical Travel……………………………………………………………123
CHAPTER SIX	CONCLUSIONS AND SUGGESTIONS……………127
1	Research Conclusions……………………………………………127
2	Managerial Implications……………………………………………135
3	Limitations and Future Research Directions……………………139
REFERENCES…………………………………………………………141
APPENDIX ………………………………………………………………155
Appendix 1 Questionnaires……………………………………………155
Appendix 2 Interview Transcripts………………………………………171

                                    

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