男性節育手術屬於一種選擇性且高度計畫性的外科手術。雖然此就醫情境賦予患者較充裕的時間進行比較與評估，但過往醫療服務利用的相關研究，鮮少完整探討全自費、非急症的就醫情境。為填補此研究缺口，本研究整合 Andersen 醫療服務利用行為模型（以下簡稱Andersen模型）、醫病信任理論與知覺價值理論，以深入探討患者在選擇診所或醫院施行手術時的決策行為。
在方法論上，本研究採用質性研究方式，透過半結構式電話訪談進行資料蒐集與分析。研究架構顯示，雖然 Andersen模型的結構性因素劃定了就醫利用的基礎邊界，但多維度的患者信任與知覺價值，則是形塑最終醫療機構選擇的關鍵因素。研究發現顯示，Andersen模型可協助整理患者就醫選擇的基礎條件，而患者對醫師或機構的信任，以及對費用、便利性、安全感與隱私的知覺價值，則進一步影響其最終選擇。
綜上所述，本研究可以填補自費醫療研究的文獻缺口，並提供一個連結結構限制、信任動態與主觀價值權衡的整體性概念架構，從而為泌尿科服務優化與醫療服務資源規劃提供具體的實證參考。

The topic of male sterilization surgery demonstrates an elective, highly planned surgical procedure. While this context provides patients with more time for comparative evaluation, prior research in healthcare utilization that fully addresses self-paid, non-emergency scenarios is rare. To fill this gap, the present study integrates the Andersen Behavioral Model of Health Service Use, the Physician-Patient Trust Theory, and the Perceived Value Theory to investigate how patients decide between clinics and hospitals for surgery.
Methodologically, this study adopted a qualitative research approach. Data was collected through semi-structured telephone interviews and analyzed using thematic analysis. Our research framework illustrates that while Andersen’s structural factors delineate baseline boundaries, multidimensional patient trust and perceived value further shape patients’ final choice of healthcare facility. In other words, the process of selecting a clinic for this surgery is driven primarily by interactional trust (benevolence and price integrity) alongside convenience and emotional value (enhanced privacy). On the other hand, patients who prefer hospitals tend to be shaped by institutional trust (e.g., reputation and accreditation) and functional value (e.g., technical competence and equipment completeness).
In sum, the current study fills a research gap on self-paid healthcare and offers a holistic framework that links structural constraints, trust dynamics, and subjective value trade-offs, thereby providing practical implications for urological service optimization and healthcare resource planning.

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