1
|
Yu Z, Hu X, Li H, Hu N, Li Y. A thematic content analysis of the structure and effects of good doctor abilities in China. BMC Health Serv Res 2024; 24:819. [PMID: 39014401 PMCID: PMC11253447 DOI: 10.1186/s12913-024-11145-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 05/23/2024] [Indexed: 07/18/2024] Open
Abstract
BACKGROUND The efforts to explore and build the structure of good doctor abilities are important because they help improve the quality of education for medical students and better standardize the working performance of doctors. However, at present, no worldwide standards for such a structure have been established. In this study, we endeavoured to map the structure of good doctor abilities and identify their effects. METHODS With a focus on China, a thematic content analysis was adopted in this study to analyse the personal profiles of 50 widely recognized good doctors. NVivo11 software was used. RESULTS The Structure and Effects of Good Doctor Abilities in China model was proposed, and interpretations were made based on AMO theory. Good doctor abilities fall within six categories: rigorous clinical thinking, skilled in diagnosis and therapy, clinical empathy, continuous learning and innovation, enhancing and sharing experiences, and communication and coordination. These abilities have positive impacts on doctors' work performances and social benefits by encouraging good behaviours, ultimately promoting the sustainable development of the hospitals where they serve. CONCLUSIONS In this study, we established a model of the structure and effects of good-doctor abilities in China and interpreted its mechanism, innovation and theory diversification in "good-doctor" research. Moreover, this study has practical significance because it provides systematic and well-targeted criteria for improving the professionalism of doctors, promoting more good doctor behaviours, providing guidance for regulating doctors' conduct and providing a reference for medical education and working performance reviews worldwide.
Collapse
Affiliation(s)
- Zhongguang Yu
- College of Economics and Management, Wuhan University, Wuhan, Hubei, 430072, China
- Respiratory Center, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Xiang Hu
- Business School, Hubei University, Wuhan, Hubei, 430062, China
| | - Hongjin Li
- Tongji Medical College, Huazhong Science and Technology University, Wuhan, Hubei, 430030, China
| | - Ning Hu
- School of Management, Beijing University of Chinese Medicine, Beijing, 102488, China
| | - Yanping Li
- College of Economics and Management, Wuhan University, Wuhan, Hubei, 430072, China.
| |
Collapse
|
2
|
Xintong Z, Tao X, Shuying W, Huq KATME, Huiying G, Michiko M. An evaluation of outpatient satisfaction based on the national standard questionnaire: a satisfaction survey conducted in a tertiary hospital in Shenyang, China. Front Public Health 2024; 12:1348426. [PMID: 38784568 PMCID: PMC11111912 DOI: 10.3389/fpubh.2024.1348426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/24/2024] [Indexed: 05/25/2024] Open
Abstract
Background Patient satisfaction survey serves as a pivotal tool in evaluating the quality of healthcare services. China's nationwide standard patient satisfaction measurement tool was introduced in 2019. This study aimed to assess the model fit of the national standard outpatient satisfaction questionnaire in a tertiary hospital and evaluate the outpatient satisfaction levels using this tool. Method A cross-sectional survey using the national outpatient satisfaction questionnaire was conducted via message links to all hospital outpatients who registered between April and July 2022. The data collected underwent descriptive analysis, comparative analysis, and confirmatory factor analysis (CFA). Results A total of 6,012 valid responses were received and analyzed during this period, with 52.9% of the participants being women. The confirmatory factor analysis (CFA) model showed a good fit and identified doctor communication as having a positive effect and environmental factors as having a negative effect on outpatients' satisfaction, with standardized regression weights of 0.46 and 0.42, respectively. Despite the remarkably high satisfaction levels, patients' recommendation for using the services of this hospital surpassed the overall evaluation and total satisfaction scores. Conclusion A disparity was identified between the expectations and real experiences of outpatients, leading to some extent of dissatisfaction. To enhance satisfaction levels, the hospital should improve the communication skills of all clinical staff, simplify the environment layout for first-time visitors, and manage patient overloads.
Collapse
Affiliation(s)
- Zhou Xintong
- Graduate School of Biomedical and Health Sciences, Division of Integrated Health Sciences, Hiroshima University, Hiroshima, Japan
- Department of Hospital Infection Management, Shenyang the Fourth People’s Hospital, Shenyang, China
| | - Xin Tao
- Department of Information, Shenyang the Fourth People’s Hospital, Shenyang, China
| | - Wang Shuying
- Department of Doctor-patient Communication, Shenyang the Fourth People’s Hospital, Shenyang, China
| | - K. A. T. M. Ehsanul Huq
- Graduate School of Biomedical and Health Sciences, Division of Integrated Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Gao Huiying
- Graduate School of Biomedical and Health Sciences, Division of Integrated Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Moriyama Michiko
- Graduate School of Biomedical and Health Sciences, Division of Integrated Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
3
|
Kang L, Zhang T, Xian B, Li C, Khan MM. Public satisfaction with health system after healthcare reform in China. Health Res Policy Syst 2023; 21:128. [PMID: 38049859 PMCID: PMC10694918 DOI: 10.1186/s12961-023-01067-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 10/30/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND The Chinese central government launched the third phase of health system reforms in 2009. After a decade since the initiation of the reform, the health system has witnessed noteworthy gains. However, there is no concurrent improvement in public satisfaction with the health system. This study analysed various factors that influence public satisfaction with the system and examined whether perceived quality of care affects public satisfaction. METHODS A longitudinal nationally representative survey was used for this study. We used five waves of China Family Panel Studies (CFPS) survey data. The final sample consisted of 145 843 observations. A two-way fixed-effects ordered logistic model was used for the analysis. RESULTS The results indicate that perceived good quality of care was positively associated with public satisfaction in health system regardless of rural-urban residence. Older adults and individuals with more than 3 years of college education were less likely to be satisfied with the system in rural areas. Personal income and the density of medical professionals in the geographic area tend to improve public satisfaction in rural areas. Having medical insurance coverage and fair or good self-rated health improved the probability of reporting public satisfaction in urban areas. Married people and individuals who lived in the West region were less likely to be satisfied with the health system in urban areas. CONCLUSIONS Knowledge and skills of healthcare providers or physical quality of facilities are not sufficient in improving public satisfaction in the health system. Policymakers need to identify options to influence the important factors that affect public perception of the system. This analysis identified several policy-amenable factors to improve public perception of the health system in rural and urban China.
Collapse
Affiliation(s)
- Lili Kang
- School of Health Management, Fujian Medical University, Fuzhou, 350122, Fujian, China
| | - Tianyi Zhang
- School of Basic Medical Sciences, Shandong University, Jinan, China
| | - Bensong Xian
- School of Health Management, Inner Mongolia Medical University, Hohhot, China
| | - Changle Li
- School of Health Management, Fujian Medical University, Fuzhou, 350122, Fujian, China.
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America.
| | - M Mahmud Khan
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, United States of America
| |
Collapse
|
4
|
Patient satisfaction and its health provider-related determinants in primary health facilities in rural China. BMC Health Serv Res 2022; 22:946. [PMID: 35883080 PMCID: PMC9316702 DOI: 10.1186/s12913-022-08349-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 07/18/2022] [Indexed: 12/17/2022] Open
Abstract
Background Patient satisfaction is an important outcome measure of health service and is one of the main reasons for the gradual deterioration of doctor–patient relationships in China. This study used the standardized patient (SP) method to explore patient satisfaction and its health provider-related determinants among primary health facilities in rural China. Methods The dataset comprised 1138 clinic cases in 728 rural primary health facilities in 31 counties, spread across four provinces. Information regarding the consultation interaction between the unannounced SPs and primary physicians was recorded. Patient satisfaction was gathered from the feedback of SPs after the visit. Results The overall average score of SP satisfaction with rural primary health facilities was only 13.65 (SD = 3.22) out of 20. The SP scores were found to be consistent with those of real patients. After controlling variances in patient population via the SP method, the regression analysis demonstrated that health provider-related factors, such as physician-level characteristics, consultation process, affordability, and convenience, have a significant correlation with patient satisfaction among primary physicians. Among factors relating to physician-level characteristics, affordability, convenience and the consultation process of the visit, the quality of the consultation process (e.g., consultation time, proactively providing necessary instructions and other crucial information) were found to be the prominent determinants. Conclusions This study revealed the need to improve patient satisfaction in primary health facilities in rural China. To solve this issue, we recommend that policies to increase medical service quality be implemented in rural primary healthcare systems. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08349-9.
Collapse
|
5
|
Chihaoui M, Oueslati I, Yazidi M, Mahjoubi S, Rezgani I, Chaker F, Mrabet A. Diabetic patient satisfaction on the quality of outpatient health care services. LA TUNISIE MEDICALE 2022; 100:161-166. [PMID: 35852252 PMCID: PMC9272683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
AIM To assess the degree of satisfaction of diabetic patients with health care services and to determine the factors that influence it. METHODS It was a cross sectional study conducted in 2018 among diabetic outpatients of the department of endocrinology of the university hospital La Rabta. Patients general characteristics were noted. Each patient responded to a questionnaire, asked orally, in Tunisian dialect, by two physicians, about health care services including 20 questions grouped into three items. Each question was scored from 1 to 4 according to the degree of satisfaction. The global score as well as the scores of the items were calculated by adding the scores of the corresponding questions. RESULTS 150 diabetic patients responded to the questionnaire; mean age: 58.9±12.2 years [18-88], sex-ratio: 0.51. Cronbach coefficient was 0.78. The overall score was 62.2±6.5 [46-80]. Ninety-seven patients (64.7%) had a score ≥60. The item concerning 'human contact and communication' was considered good in 98% of cases. The item concerning 'premises, cleanliness, comfort and safety' was considered intermediate in 64% of cases. Patients were very satisfied with the accessibility of the department inside the hospital (76.7%), the attitude of the agents during the administrative formalities (74%) and particularly the behaviour of the doctor (96%). However, they were dissatisfied with the noise (72%) and overcrowding (67.4%) of the waiting room. There were no statistically significant associations between the overall score and the studied data. CONCLUSION The diabetic patients were overall satisfied with the provided services. Actions must be taken to reduce overcrowding and long waiting times.
Collapse
|
6
|
Zhou X, He Q, Li Q, Kuang J, Han Y, Chen J. Factors Associated with Outpatient Satisfaction in Provincial Tertiary Hospitals in Nanchang, China: A Structural Equation Modeling Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148226. [PMID: 35886078 PMCID: PMC9351663 DOI: 10.3390/ijerph19148226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022]
Abstract
Outpatient satisfaction is important in evaluating the performance of tertiary public hospitals in China. However, only a few studies have examined the interaction between outpatient satisfaction and its related factors. This study aimed to explore the relationship between patient satisfaction and its related factors in provincial tertiary hospitals. Six hundred outpatients in three provincial tertiary hospitals in Nanchang, China, were randomly selected. Structural equation modeling was used to analyze the relationship of the factors associated with outpatient satisfaction. The conceptual model fitted the data well (χ2/df = 4.367, CFI = 0.951, TLI = 0.937, SRMR = 0.055, RMSEA = 0.075), with all the path coefficients being statistically significant (p < 0.001). The environment and facilities showed the most significant influence on outpatient satisfaction (standardized total effect = 0.389), followed by the quality of diagnosis and treatment (standardized total effect = 0.235). The waiting time for medical services showed a partial mediation effect of 0.077 between the environment and facilities and outpatient satisfaction. The study indicates that targeted measures should be taken to improve the amenities of hospitals and shorten the waiting time for medical services, thus further improving outpatients’ medical experience.
Collapse
Affiliation(s)
- Xiaojun Zhou
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (X.Z.); (Q.H.); (Q.L.); (J.K.)
| | - Qiuwen He
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (X.Z.); (Q.H.); (Q.L.); (J.K.)
| | - Qi Li
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (X.Z.); (Q.H.); (Q.L.); (J.K.)
| | - Jie Kuang
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (X.Z.); (Q.H.); (Q.L.); (J.K.)
| | - Yalan Han
- Library of Nanchang University, Nanchang University, Nanchang 330006, China;
| | - Jiayan Chen
- Jiangxi Province Key Laboratory of Preventive Medicine, School of Public Health, Nanchang University, Nanchang 330006, China; (X.Z.); (Q.H.); (Q.L.); (J.K.)
- Correspondence: ; Tel.: +86-0791-86362283
| |
Collapse
|
7
|
The Association between mHealth App Use and Healthcare Satisfaction among Clients at Outpatient Clinics: A Cross-Sectional Study in Inner Mongolia, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116916. [PMID: 35682498 PMCID: PMC9180655 DOI: 10.3390/ijerph19116916] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/31/2022] [Accepted: 06/02/2022] [Indexed: 01/27/2023]
Abstract
Mobile health (mHealth) applications (apps) have been developed in hospital settings to allocate and manage medical care services, which is one of the national strategies to improve health care in China. Little is known about the comprehensive effects of hospital-based mHealth app use on client satisfaction. The aim of this study was to determine the relationship between the full range of mHealth app use and satisfaction domains among clients attending outpatient clinics. A cross-sectional survey was conducted from January to February 2021 in twelve tertiary hospitals in Inner Mongolia. After the construction of the mHealth app use, structural equation modeling was used for data analysis. Of 1889 participants, the standardized coefficients β on environment/convenience, health information, and medical service fees were 0.11 (p < 0.001), 0.06 (p = 0.039), and 0.08 (p = 0.004), respectively. However, app use was not significantly associated with satisfaction of doctor−patient communication (β = 0.05, p = 0.069), short-term outcomes (β = 0.05, p = 0.054), and general satisfaction (β = 0.02, p = 0.429). Clients of the study hospitals were satisfied with the services, but their satisfaction was not much associated with mHealth use. The limitation of the mHealth system should be improved to enhance communication and engagement among clients, doctors, and healthcare givers, as well as to pay more attention to health outcomes and satisfaction of clients.
Collapse
|
8
|
Feng X, Zhu J, Hua Z, Zhou Q, Shi A, Song T, Yao S, Chen R, Wei W, Zhou J. Satisfaction in population-based cancer screening in a Chinese rural high-risk population: the Yangzhong early diagnosis and treatment of upper gastrointestinal cancer. BMC Health Serv Res 2022; 22:675. [PMID: 35590328 PMCID: PMC9121570 DOI: 10.1186/s12913-022-08076-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 05/09/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Screening for upper gastrointestinal cancer (UGC) effectively reduces morbidity and mortality in gastric and esophageal cancers. It is considered one of the effective measures for cancer control in China, but studies on its functional quality are lacking. Our study assessed the quality of screening service funded by Upper Gastrointestinal Cancer Early diagnosis and treatment (UGCEDAT) and its correlation in Yangzhong People's hospital, China. METHODS A cross-sectional study was conducted among 516 screening users at a screening centre in Yanghzong People's hospital from April to July 2021. The service quality questionnaire (SERVQUAL) based on the service quality gap (SQG) model was adopted. We calculated the mean scores of perceptions and expectations and their gap. To determine the association between overall SQG and related features of participants, we used a multivariate logistic regression. RESULTS The average scores of screening service users' perceptions and expectations were 4.05 and 4.55, respectively. The SQG of five dimensions (tangibles, reliability, responsiveness, assurance and empathy) were negative, and the overall SQG was -0.51. The responsiveness dimension had the largest gap, and tangibles had the smallest gap. Occupation status (AOR: 0.57; CI: 0.37-0.89), health self-assessment (AOR: 4.97; CI: 1.35-18.23), endoscopy experience (AOR: 0.55; CI: 0.38-0.81), distance from screening hospital (AOR: 1.85; CI: 1.25-2.73) and frequency of visit (AOR: 1.65; CI: 1.10-2.46) were associated with the overall SQG. CONCLUSIONS We observed a negative gap between perceptions and expectations of the function quality of screening service, implying a high dissatisfaction across different dimensions. Service providers should take adequate measures to bridge the dimension with the largest quality gap. Meanwhile, attention should be paid to identifying the influencing factors of the overall SQG and the characteristics of dimensional expectations and perceptions to improve the effectiveness of the screening program.
Collapse
Affiliation(s)
- Xiang Feng
- Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Yangzhong, China.
| | - Jinhua Zhu
- Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Zhaolai Hua
- Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Qin Zhou
- Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Aiwu Shi
- Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Tongqiu Song
- Institute of Tumour Prevention and Control, People's Hospital of Yangzhong City, Yangzhong, China
| | - Shenghua Yao
- Endoscopy Center, People's Hospital of Yangzhong City, Yangzhong, China
| | - Ru Chen
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Wenqiang Wei
- Cancer Registry Office, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Jinyi Zhou
- Department of Non-Communicable Disease Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| |
Collapse
|
9
|
Yin S, Hu M, Chen W. Quality Perceptions and Choice of Public Health Facilities: A Mediation Effect Analysis of Outpatient Experience in Rural China. Patient Prefer Adherence 2022; 16:2089-2102. [PMID: 35983546 PMCID: PMC9381010 DOI: 10.2147/ppa.s370805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 08/02/2022] [Indexed: 01/10/2023] Open
Abstract
PURPOSE Outpatients have choices of providers in the hierarchical health service delivery system of China. Understanding how quality perceptions and outpatient experience affect the choice of health facility would help inform decisions about priorities for action aimed at guiding the use of primary care. This study examines how quality perceptions of outpatient service affect the facility level choice in rural China. METHODS Household surveys were conducted in 2011, 2012 and 2015 in Ningxia Hui Autonomous Region, China. We selected 968 respondents as the study sample, who had at least two outpatient visits to the public health facilities during each survey period. Prior quality perceptions of the outpatient service at the village clinics, township centers, and county hospitals were reported on an 8-item Quality Indicator questionnaire. Experienced quality perception from the first outpatient visit was also reported. The outcome of interest was outpatients' facility level choices. We used regression and mediation analysis to explore whether and how outpatient experience at a specific health facility would mediate the relationship between prior quality perceptions and the facility level choice. RESULTS Overall, the quality perception was positively and significantly associated with outpatients' staying at the same or lower levels of care (β=0.265, P=0.007). This effect was fully mediated by experienced quality perception (z=2.985, P=0.003). The indirect effect was significant for three particular dimensions, including quality perceptions of the environment (β=0.075, P=0.025), doctor-patient communication (β=0.065, P=0.022), and physician ability (β=0.062, P=0.021). CONCLUSION Outpatient quality perceptions-especially positive perceptions regarding environment, doctor-patient communication, and physician ability-could contribute to minimizing upward referral via improvement in outpatient experience. Policymakers and health care providers may need to therefore optimize outpatient experience as they push to develop a more locally responsive primary care system.
Collapse
Affiliation(s)
- Shuying Yin
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Research Department I, Shenzhen Health Development Research and Data Management Center, Shenzhen, People’s Republic of China
| | - Min Hu
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
| | - Wen Chen
- Department of Health Economics, School of Public Health, Fudan University, Shanghai, People’s Republic of China
- Correspondence: Wen Chen; Min Hu, The Department of Health Economics, School of Public Health, Fudan University, No. 187 Box, 138 Yixueyuan Road, Xuhui District, Shanghai, 200032, People’s Republic of China, Tel +86 13818325486; +86 17717031079, Email ;
| |
Collapse
|
10
|
Liang H, Xue Y, Zhang ZR. Patient satisfaction in China: a national survey of inpatients and outpatients. BMJ Open 2021; 11:e049570. [PMID: 34493518 PMCID: PMC8424834 DOI: 10.1136/bmjopen-2021-049570] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 08/24/2021] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES Patient satisfaction is an important indicator of hospital healthcare quality. Little up-to-date information of patient satisfaction in China is available. This study attempts to gain a holistic understanding of patient satisfaction in China and identify the key antecedents of patient satisfaction. DESIGN A cross-sectional national survey was conducted in 2018. SETTING Hospitals in 27 provinces and 4 municipalities in 4 regions of China. PARTICIPANTS A random sample of 15 699 patients who visited 1304 hospitals were surveyed, with around 500 from each of the 27 provinces and 4 municipalities. PRIMARY AND SECONDARY OUTCOME MEASURES The Hospital Consumer Assessment of Healthcare Providers and Systems questionnaire was used to measure patients' overall satisfaction and willingness to recommend the hospital. RESULTS We found significant variation in overall patient satisfaction but little variation in hospital recommendation across the four broad regions. Moreover, we examined determinants of patient satisfaction and their likelihood to recommend the hospital. The overall satisfaction for inpatients and outpatients is commonly influenced by communication with doctors (inpatient: β=0.524, p<0.001; outpatient: β=0.541, p<0.001), hospital cleanness (inpatient: β=0.165, p<0.05; outpatient: β=0.144, p<0.001) and acceptable charges (inpatient: β=1.481, p<0.001; outpatient: β=1.045, p<0.001). Both inpatients and outpatients are more likely to recommend the hospital if there are communication with doctors (inpatient: OR=1.743, p<0.001; outpatient: OR=1.647, p<0.001), acceptable charges (inpatient: OR=2.660, p<0.001; outpatient: OR=2.433, p<0.001). Outpatient satisfaction and hospital recommendation are also influenced by time spent with doctors (satisfaction: β=0.301, p<0.001; recommend: OR=1.430, p<0.001) and waiting time (satisfaction: β=-0.318, p<0.001; recommend: OR=0.844, p<0.001). CONCLUSIONS There are regional differences of patient satisfaction in China. Patient satisfaction is influenced by a variety of hospital factors and province/municipality factors. The influencing factors of patient satisfaction may not motivate patients to recommend the hospital.
Collapse
Affiliation(s)
- Huigang Liang
- Business and Information Technology, The University of Memphis, Memphis, Tennessee, USA
| | - Yajiong Xue
- Management Information Systems, East Carolina University, Greenville, North Carolina, USA
| | - Zhi-Ruo Zhang
- Community Health & Behavioral Medicine, Shanghai Jiao Tong University, Shanghai, Shanghai, China
| |
Collapse
|
11
|
Zhou F, Xu C, Sun Y, Meng X. Influencing Factors of Outpatients' Satisfaction in China a Cross-Sectional Study of 16 Public Tertiary Hospitals. Patient Prefer Adherence 2021; 15:1243-1258. [PMID: 34135576 PMCID: PMC8200138 DOI: 10.2147/ppa.s311786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 05/19/2021] [Indexed: 12/14/2022] Open
Abstract
PURPOSE This study aimed to analyze the status of patient satisfaction in outpatients of tertiary hospitals and the factors affecting patient satisfaction, in order to provide a scientific basis for improving patient satisfaction. METHODS A total of 6480 surveys of outpatients were conducted by a cross-sectional study in 16 tertiary hospitals in the Zhejiang province of China. The main contents of the survey were the basic characteristics of patients. Statistical description, single-factor analysis and binary logistic regression analysis were used to screen influencing factors. RESULTS Results of this study showed that the total satisfaction score of outpatients was 87.13±13.47, and higher scored factors in the survey factors were nursing level, the convenience of registration and convenience of appointment diagnosis and treatment. The factors with lower scores were treatment effect, environmental sanitation and comfort and other staffs' attitudes. Hospital managers should pay attention to the improvement of treatment level, environmental sanitation and comfort and other staffs' attitudes. CONCLUSION In the process of serving outpatients, doctors should pay more attention to patients who are male, 31-45 years old or over 60 years old, permanent residents, from public institutions, possessed postgraduate education, without medical insurance, and who visiting paediatrics and Chinese medicine hospitals.
Collapse
Affiliation(s)
- Fangwei Zhou
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Caiming Xu
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Yanxiang Sun
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
| | - Xuehui Meng
- Humanities and Management School, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, People’s Republic of China
- Correspondence: Xuehui Meng Humanities and Management School of Zhejiang Chinese Medical University, 548# Binwen Road, Binjiang District, Hangzhou, 310051, People’s Republic of ChinaTel/Fax +86 571-86633056 Email
| |
Collapse
|
12
|
Sun Z, Wang S, Zhao H, Yu H. Does Descending Resources Reform Improve Patient Satisfaction and Reshape Choice of Care Providers? A Cross-Sectional Study in Zhejiang, China. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2020; 57:46958020956899. [PMID: 32909479 PMCID: PMC7488616 DOI: 10.1177/0046958020956899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Patient satisfaction and choice of care providers have been the core concerns of
China’s descending resources reform launched in 2013. This health care reform
attempts to improve low-level hospitals’ capability and patient satisfaction
through compulsory descending of doctors from high-level hospitals, thereby
reshaping patients’ behavior (loyalty). The goal of this paper is to explore the
determinants of patient satisfaction, and its impact on patient loyalty with an
emphasis on low-level hospitals in the reform context. By using a self-made
5-point scale that incorporates socio-demographic variables, reform, and
revealed preference into the European Consumer Satisfaction Index model (ECSI),
cross-sectional data from 17 hospitals, and 1287 questionnaires in Zhejiang
province is collected to conduct empirical research. Satisfaction is measured as
ordinary variables with the reform and with the low-level hospitals,
respectively. Loyalty is measured by patients’ willingness to choose low-level
hospitals when suffering illness or severe illness. Analysis of variance and
multiple comparisons are utilized to examine the different level of hospitals.
An ordered logit model and ordinary least squares regression are applied to
examine the determinants of satisfaction and loyalty. The results indicate that
patient satisfaction can be explained by variables of perceived quality, patient
expectations, and corporate image. Socio-demographic variable, providers, and
the reform also have significant effects. Patients’ satisfaction plays a
pronounced role on improving their loyalty. The descending resources reform
positively affects low-level hospitals’ capability and patient satisfaction. The
cost reduction and convenience significantly increase the reform satisfaction.
Capability, medical environment, and accessibility of descending doctors are
positively associated with the satisfaction with low-level hospitals. This paper
evidences that the descending resources reform is an effective way to reallocate
resources in supply side of health service market and reshape patients’ choice
of care providers with the accessibility and spillover of descending human
capital.
Collapse
Affiliation(s)
- Zesheng Sun
- School of Finance and Business, Shanghai Normal University, China
| | - Shuhong Wang
- Department of Stomatology, Tongde Hospital of Zhejiang Province, Hangzhou, China.,Department of Stomatology, First People's Hospital of Akesu, China
| | - Hongjun Zhao
- School of Finance and Business, Shanghai Normal University, China
| | - Haiming Yu
- School of Economics and Management, Zhejiang University of Science and Technology, Hangzhou, China
| |
Collapse
|
13
|
Perceived quality of care and its associated factors among Chinese patients with advanced cancer: findings from the APPROACH study in Beijing. Support Care Cancer 2020; 29:1395-1401. [PMID: 32671564 DOI: 10.1007/s00520-020-05559-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 05/28/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Patient-perceived quality of care has become an increasingly important index within the healthcare setting. We examined patient-reported overall quality of care and patient experiences in three specific domains of care (physician communication, nursing care, and care coordination) in a sample of Chinese patients with advanced cancer. METHODS A cross-sectional study was conducted with stage IV cancer patients (N = 202) who were recruited from a public, tertiary hospital in Beijing. Study participants completed surveys administered by a research assistant. Multivariable regression analysis was conducted to examine the extent to which patient demographic factors (age, gender, socioeconomic status), disease/treatment factors, and domain-specific care were associated with overall quality of care. RESULTS A majority of patients reported overall quality of care scores that we were either excellent (23%) or very good (41%). Patients reported highest ratings in the domain of nursing care (M = 87.57, SD = 31.05), followed by physician communication (M = 68.93, SD = 32.30), and care coordination (M = 66.79, SD = 25.17). Better perceived physician communication (b = 0.17, p < 0.01), care coordination (b = 0.26, p < 0.01), and higher socioeconomic status (b = 11.30, p < 0.05) were associated with higher overall quality of care. CONCLUSIONS A majority of patients with advanced cancer in this Chinese hospital reported positive overall quality of care. Physician communication and care coordination are potential areas to focus on to improve patient-reported overall quality of care. Understanding perceptions of care quality will allow opportunities to improve delivery of healthcare.
Collapse
|