The study purposes were to construct and test structural equation modeling on the causal relationship of community residents' perceived quality of care, image, and role performance with satisfaction, intention to (re)visit and intention to recommend hospital.

A cross-sectional survey was conducted with 3,900 community residents from 39 district public hospitals. The questionnaire was designed to collected information on personal characteristics and community awareness of public hospitals. Community awareness consisted of 6 factors and 18 items. The data were collected utilizing call-interview by a survey company. Research data were collected via questionnaires and analyzed using SPSS version 20.0 and AMOS version 20.0.

Model fit indices for the hypothetical model were suitable for the recommended level: χ²=796.40 (df=79, p <.001), GFI=.93, AGFI=.90, RMSR=.08, NFI=.94. Quality of care, image, and role performance explained 68.1% of variance in community awareness. Total effect of quality of care process factors on satisfaction (path coefficients=3.67), intention to (re)visit (path coefficients=2.67) and intention to recommend hospital (coefficients=2.45) were higher than other factors.

Findings show that public hospitals have to make an effort to improve community image through the provision of quality care, and excellent role performance. Support for these activities is available from both Central and Local Governments.

This study was done to assess the educational needs that should be considered in developing curriculum for staff in charge of public health services in public hospitals.

The participants in this study were staff in charge of public health services in 130 public hospitals. The Borich's Needs Assessment Model which analyzed the relation of 'required competence level' and 'present competence level', was utilized. Data were collected from October to November 2007 using a structure self-report questionnaire. The return rate was 66.9%. The Cronbach's alpha score was 0.959.

The mean scores for 'required competence level', 'present competence level' and Borich's need were 4.02, 3.44, and 2.30 respectively. According to public health service items, 'strategies to recognize the present condition and analyze problems' had the highest score for Borich's need, but 'establishment of annual or monthly objectives' had the lowest score for Borich's need.

Education was found to be very important for staff carrying out public health services. Ultimately the results of this study may be utilized to develop education program for staff carrying out public health services in public hospitals.