The influences of patient's satisfaction with medical service delivery, assessment of medical service, and trust in health delivery system on patient's life satisfaction in China

Primary medical and health preparedness and people's life satisfaction in China: The mediating role of satisfaction with medical and health services

Objective

To examine the association between primary medical and health preparedness (PMHP), satisfaction with medical and health services (SMHS), and life satisfaction (LS).

Methods

Using the latest national representative data from the 2019 Chinese Social Survey and the 2018 Health Statistics Yearbook for each province in China, we conducted multi-level models to test the effect of three aspects of PMHP (the number of primary medical and health institutions (PMHIs), the number of beds in PMHIs, and the number of staff in PMHIs) on LS, and the mediation role of SMHS in this effect.

Results

The number of staff in PMHIs has a significant positive effect on people's LS. Besides, this effect is mediated completely by SMHS. However, the number of PMHIs and the number of beds in PMHIs do not affect LS significantly.

Conclusions

PMHP has a positive impact on LS, but this impact is associated only with the number of staff in PMHIs. Therefore, governments should focus on optimizing human resources in PMHIs to meet the LS needs of individuals.

Patterns of Outpatient Service Satisfaction among Low-Income Adults in Rural China: A Latent Class Analysis

(1) Background: Low-income rural residents in China are disadvantaged due to their financial vulnerability and insufficient access to resources, and this situation demands more research effort. This study examined the pattern of outpatient service satisfaction and its determinants among low-income adults in rural China. (2) Methods: Rural low-income respondents who used outpatient services in their local healthcare facilities in Jiangsu, China evaluated the access, cost, environment, doctor–patient interaction, and other topics during their outpatient visit (N = 662). Latent class analysis was used to identify the groups characterized by various dimensions of outpatient satisfaction. Multinomial logistic regression explored the determinants of class membership. (3) Results: Three latent classes were identified: 28.70% had low satisfaction, unsatisfied with every dimension; 20.69% reported medium satisfaction that valued doctor–patient relationships; and 50.60% had high satisfaction but thought that costs were high. Both low and medium satisfaction were associated with a higher proportion of self-paid fees. (4) Conclusions: Healthcare costs were an important determinant of outpatient service satisfaction. Medical social workers are suggested to be included in the medical team to help patients identify financial assistance. Special aid programs may be developed to help relieve rural low-income patients’ medical cost-related burden.

Factors Associated with Outpatient Satisfaction in Provincial Tertiary Hospitals in Nanchang, China: A Structural Equation Modeling Approach

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.

The Association between mHealth App Use and Healthcare Satisfaction among Clients at Outpatient Clinics: A Cross-Sectional Study in Inner Mongolia, China

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.

Patient Satisfaction and Hospital Quality of Care Evaluation in Malaysia Using SERVQUAL and Facebook

Social media sites, dubbed patient online reviews (POR), have been proposed as new methods for assessing patient satisfaction and monitoring quality of care. However, the unstructured nature of POR data derived from social media creates a number of challenges. The objectives of this research were to identify service quality (SERVQUAL) dimensions automatically from hospital Facebook reviews using a machine learning classifier, and to examine their associations with patient dissatisfaction. From January 2017 to December 2019, empirical research was conducted in which POR were gathered from the official Facebook page of Malaysian public hospitals. To find SERVQUAL dimensions in POR, a machine learning topic classification utilising supervised learning was developed, and this study's objective was established using logistic regression analysis. It was discovered that 73.5% of patients were satisfied with the public hospital service, whereas 26.5% were dissatisfied. SERVQUAL dimensions identified were 13.2% reviews of tangible, 68.9% of reliability, 6.8% of responsiveness, 19.5% of assurance, and 64.3% of empathy. After controlling for hospital variables, all SERVQUAL dimensions except tangible and assurance were shown to be significantly related with patient dissatisfaction (reliability, p < 0.001; responsiveness, p = 0.016; and empathy, p < 0.001). Rural hospitals had a higher probability of patient dissatisfaction (p < 0.001). Therefore, POR, assisted by machine learning technologies, provided a pragmatic and feasible way for capturing patient perceptions of care quality and supplementing conventional patient satisfaction surveys. The findings offer critical information that will assist healthcare authorities in capitalising on POR by monitoring and evaluating the quality of services in real time.

Primary Healthcare Under Transformation in 3 Eastern European Countries: Quality Satisfaction as Rated by Students

Objectives

This study aimed to determine the reasons for student dissatisfaction with the quality of primary healthcare (PHC) in countries under healthcare system transformation (Belarus, Poland, and Ukraine) to identify reserves and make improvements.

Methods

A comparative multipopulation survey was translated, verified, and completed during face-to-face interviews during March 2019 to May 2019. There were 700 Humanities students included in this study to determine satisfaction with the quality of PHC provided by the family doctor. Satisfaction was assessed according to the availability of the doctor, the level of organization of the institution, the service process, the quality of the interaction with the doctor, adherence to the rights of patients, and any additional financial expense incurred by the patient.

Results

Politeness and attentiveness of doctors were rated highly. Dissatisfaction was associated with the negative attitude of medical personnel towards the patient. One in 10 respondents replied that medical confidentiality was not observed. More than 65% of students had paid for diagnostic tests/or treatments, and some respondents from Poland and Ukraine were asked by the doctor to pay for services without a receipt.

Conclusion

Dissatisfaction with the quality of PHC in countries under transformation of the health system was largely due to ethical aspects of the doctor-patient relationship. Therefore, ethical standards need to be upheld and patients need to be aware of these standards using medical education materials covering the moral aspects of the relationship between medical personnel and patient.

The Relationship between Face-to-Face and Online Patient-Provider Communication: Examining the Moderating Roles of Patient Trust and Patient Satisfaction

Patient-provider communication is an important factor influencing patients' health-related outcomes. This study examined how the quality of face-to-face communication with providers is associated with their subsequent Internet use for patient-provider communication. With an analysis of two-wave panel data collected in China, results showed that face-to-face patient-provider communication had a positive and direct effect on online patient-provider communication at a later time point. In addition, patient trust and patient satisfaction both positively moderated the relationship between face-to-face and online patient-provider communication. The results of this study emphasized the important roles of patient-centered communication and patient-provider relationship in the process of eHealth and mHealth movement, particularly in the Chinese health care system.

Combining Direct and Indirect Measurements to Assess Patients' Satisfaction with the Quality of Public Health Services in Romania: Uncovering Structural Mechanisms and Their Implications

Introduction: Patients' satisfaction was extensively researched over the last decades, given its role in building loyalty, compliance to treatment, prevention, and eventually higher levels of wellbeing and improved health status. Patients' feedback on the perceived quality of health services can be incorporated into practice; therefore, understanding factors and mechanisms responsible for patients' satisfaction allows providers to tailor targeted interventions. Method: A questionnaire assessing patients' perception of the quality of health services was administered to a country-representative sample of 1500 Romanian patients. Using a partial least squares-path modeling approach (PLS-PM), with cross-sectional data, we developed a variance-based structural model, emphasizing the mediating role of trust and satisfaction with various categories of health services. Results: We confirmed the mediating role of trust in shaping the relationship between the procedural accuracy of health professionals, along with the perceived intensity of their interaction with patients, and patients' experienced quality of the health services. We confirmed the mediating role of satisfaction by the categories of services in the relationship between waiting time on the premises, attention received, and the perceived reliability of the information received, as predictors, and the experienced quality of the health services. In addition, indirect assessment of patients' satisfaction is a good predictor for direct assessment, thereby affirming the idea that the results of the two types of evaluations converge. Discussions: One of the most efficient solutions to increase both patients' satisfaction and their compliance is to empower the communication dimension between patients and health practitioners. Given the non-linear relationships among variables, we advocate that, unless the nature of the relationships between satisfaction and its predictors is understood, practical interventions could fail. The most relevant variable for intervention is the degree of attention patients perceive they received. We suggest three methods to turn waiting time into attention given to patients.

How Does Online Patient-Provider Communication Heal? Examining the Role of Patient Satisfaction and Communication Experience in China

China is facing the problem of having health care that is difficult to access. Online patient-provider communication (OPPC) may bring a new option to deliver health services. However, online communication with doctors is still novel to many people in China. Little research has been conducted to examine how OPPC could improve health outcomes. With an integrated model that incorporates social cognitive theory into the three-stage model of health promotion using interactive media, this study tested the social mechanism underlying the impact of OPPC. Results indicated that self-efficacy, behavioral capability, and outcome expectation positively predicted OPPC at Stage 1, which in turn increased patient satisfaction at Stage 2, which finally improved three types of health outcomes (general, emotional, and physical) at Stage 3. In addition, quality of users' experience in OPPC positively moderated this mediation pathway. Theoretical and practical implications of this study were also discussed.

Do job stress, health, and presenteeism differ between Chinese healthcare workers in public and private hospitals: a cross sectional study

To determine if job stress, health, and presenteeism differ between healthcare workers at Chinese public and private hospitals. This cross-sectional study analyzed the records of 1080 healthcare workers in eastern, central, and western China for the period from January2015 through November2015. Data on challenge stress, hindrance stress, health, and presenteeism were collected. Using univariate and multivariate regression and SPSS, we investigated differences between Chinese public and private hospitals in China. Challenge stress, hindrance stress, and presenteeism, but not health status, significantly differed between healthcare workers at public and private hospitals in China. Challenge stress and hindrance stress were significantly higher in public hospitals, while presenteeism was significantly lower in private hospitals. The significant differences between public and private hospitals are attributable to differences in the business practices and management of public and private hospitals. To achieve successful long-term medical reform in China, the adverse effects of psychosocial factors should be considered in future research plans and policies. Chinese hospitals urgently require improvements in management and leadership. Reform efforts should encompass fields such as management science, psychology, and the behavioral sciences.

Helping the decision maker effectively promote various experts' views into various optimal solutions to China's institutional problem of health care provider selection through the organization of a pilot health care provider research system

BACKGROUND

The main aim of China's Health Care System Reform was to help the decision maker find the optimal solution to China's institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China's health care system, and it could efficiently collect the data for determining the optimal solution to China's institutional problem of health care provider selection from various experts, then the purpose of this study was to apply the optimal implementation methodology to help the decision maker effectively promote various experts' views into various optimal solutions to this problem under the support of this pilot system.

METHODS

After the general framework of China's institutional problem of health care provider selection was established, this study collaborated with the National Bureau of Statistics of China to commission a large-scale 2009 to 2010 national expert survey (n = 3,914) through the organization of a pilot health care provider research system for the first time in China, and the analytic network process (ANP) implementation methodology was adopted to analyze the dataset from this survey.

RESULTS

The market-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the doctors' point of view; the traditional government's regulation-oriented health care provider approach was the optimal solution to China's institutional problem of health care provider selection from the pharmacists' point of view, the hospital administrators' point of view, and the point of view of health officials in health administration departments; the public private partnership (PPP) approach was the optimal solution to China's institutional problem of health care provider selection from the nurses' point of view, the point of view of officials in medical insurance agencies, and the health care researchers' point of view.

CONCLUSIONS

The data collected through a pilot health care provider research system in the 2009 to 2010 national expert survey could help the decision maker effectively promote various experts' views into various optimal solutions to China's institutional problem of health care provider selection.