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Yan J. An Analysis of Inpatient Satisfaction with Trust-related Factors of Public Secondary and Tertiary Hospitals in China. Qual Manag Health Care 2024; 33:166-175. [PMID: 38941583 DOI: 10.1097/qmh.0000000000000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND OBJECTIVES Patient satisfaction surveys are implemented as an essential quality improvement tool in healthcare markets. This study investigates patient satisfaction in public secondary and tertiary hospitals and identifies factors contributing to inpatient satisfaction, particularly trust-related factors, to eventually improve the quality of care in the healthcare system. METHODS A population-based cross-sectional survey was conducted between February and April 2021 in 31 Chinese provinces. Telephone interviews with computer assistance were used to gather data. Spearman Rank Correlation was used to analyze satisfaction with hospitalization services between secondary and tertiary hospitals. Multiple Linear Regression was used to determine the influencing factors of overall patient satisfaction. RESULTS Inpatients reported more satisfaction with inpatient care when doctors treated them respectfully (p < 0.01). Inpatients with higher self-identified social class reported higher satisfaction (p < 0.01). Inpatients who trust in most people in society (p < 0.01) and trust in the Chinese healthcare system (p < 0.01) reported higher satisfaction. Female inpatients reported higher overall satisfaction (p < 0.01). CONCLUSIONS The study of Chinese inpatients in secondary and tertiary hospitals highlighted the importance of respect from doctors, their self-identified social class, and their trust in influencing satisfaction during their hospital stay and called for additional research into policy measures.
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Affiliation(s)
- Jingjing Yan
- Author Affiliation: Department of Public Administration, College of Philosophy, Law & Political Science, Shanghai Normal University, Shanghai, China
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2
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Sun Y, Wang H, Wu Y, Luo L, Shi C. Parents' knowledge and attitudes towards extracorporeal membrane oxygenation and their post-traumatic stress symptoms. Sci Rep 2024; 14:10700. [PMID: 38730232 PMCID: PMC11087580 DOI: 10.1038/s41598-024-60880-3] [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: 02/06/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
This cross-sectional study, conducted between January 2020 and July 2023, aimed to assess the knowledge, attitude, and post-traumatic stress symptoms (PTSS) among parents with children undergoing extracorporeal membrane oxygenation (ECMO) treatment. Out of 201 valid questionnaires collected, the median knowledge score was 3.00, the mean attitude score was 27.00 ± 3.20, and the mean PTSS score was 3.50 ± 1.54. Logistic regression identified associations between PTSS and parents with lower education levels, particularly junior high school and high school/technical secondary school education, as well as those occupied as housewives. Structural equation modeling highlighted direct effects, such as the impact of residence on education, education on employment status, and associations between knowledge, attitude, PTSS, employment status, monthly income, and parental demographics. The findings indicated inadequate knowledge and suboptimal attitudes among parents, especially those with lower education levels, emphasizing the need for educational resources. Furthermore, addressing parental PTSS through psychosocial support and screening was deemed essential, providing valuable insights for tailored interventions in this context.
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Affiliation(s)
- Yuyan Sun
- Surgical Intensive Care Unit, Henan Children's Hospital Zhengzhou Children's Hospital, Henan, 450018, China
| | - Huanhuan Wang
- Surgical Intensive Care Unit, Henan Children's Hospital Zhengzhou Children's Hospital, Henan, 450018, China
| | - Yingying Wu
- Rehabilitation Department, Henan Children's Hospital Zhengzhou Children's Hospital, Henan, 450053, China
| | - Leng Luo
- Surgical Intensive Care Unit, Henan Children's Hospital Zhengzhou Children's Hospital, Henan, 450018, China
| | - Caixiao Shi
- Nursing Department, Henan Children's Hospital Zhengzhou Children's Hospital, Henan, 450018, China.
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PATIENT SATISFACTION WITH INTERPERSONAL COOPERATION AND HEALTH SERVICES AT THE LEVEL OF PRIMARY AND SECONDARY HEALTH CARE. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2022. [DOI: 10.33457/ijhsrp.1094928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Interprofessional cooperation and teamwork among health professionals in the health care system are crucial for improving patient satisfaction and quality of health services. The aim of the research is to examine the satisfaction of patients with interpersonal cooperation and health services provided at the level of primary and secondary health care. The research was done as a cross-sectional study and was conducted at the Niksic General Hospital and two health centers in Podgorica. The sample consisted of 154 respondents, both sexes. The research used a questionnaire for health care users designed for the purposes of this research. The questionnaire consists of a general and a specific part. Descriptive statistics measures and x2 test were used for statistical data processing. The results of the research show that there is a statistically significant correlation between gender and patient satisfaction with services χ² (2, N = 154) = 104.117, p = 0.000, as well as between age and patient satisfaction with services χ² (6, N = 154) = 139.294, p = 0.000. Understanding interpersonal cooperation is important for improving the efficiency of health care, its organization and customer satisfaction.
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Lu P, Yang C, Yao J, Xian M, Shelley M. Patterns of Outpatient Service Satisfaction among Low-Income Adults in Rural China: A Latent Class Analysis. Healthcare (Basel) 2022; 10:healthcare10081380. [PMID: 35893202 PMCID: PMC9330119 DOI: 10.3390/healthcare10081380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 11/16/2022] Open
Abstract
(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.
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Affiliation(s)
- Peiyi Lu
- Departments of Political Science and Statistics, Iowa State University, Ames, IA 50011, USA; (P.L.); (M.S.)
| | - Chunyu Yang
- College of Law and Political Science, Institute of Climate Change and Public Policy, Nanjing University of Information Science and Technology, Nanjing 210044, China;
| | - Jun Yao
- School of Health Policy & Management, Institute of Healthy Jiangsu Development, Nanjing Medical University, Nanjing 211166, China
- Correspondence:
| | - Mingxia Xian
- School of Political Science and Public Administration, Soochow University, Suzhou 215123, China;
| | - Mack Shelley
- Departments of Political Science and Statistics, Iowa State University, Ames, IA 50011, USA; (P.L.); (M.S.)
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Fiakpa EA, Nguyen TH, Armstrong A. Assessing service quality and the perceptual difference between employees and patients of public hospitals in a developing country. INTERNATIONAL JOURNAL OF QUALITY AND SERVICE SCIENCES 2022. [DOI: 10.1108/ijqss-09-2021-0127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to examine service quality in Nigerian general hospitals and determines possible differences in service quality perceptions between employees and patients.
Design/methodology/approach
Using the Servqual scale, data was collected from 328 employees and patients of two government hospitals in Abuja and Delta states. Analysis was carried out using SPSS 26 package for constructs reliability frequency, mean, standard deviation and t-statistics.
Findings
The study found significant differences in the perception of service quality between employees and patients of the Nigerian general hospitals. While employees gave a high rating to empathy, patients rated it low. Also, the patients’ poor perception of tangible did not match the employees’ high perception. Other specific findings are patients’ unfavourable assessment of the physical facilities and judged the staff to lack professional dressing. Patients felt the hospitals could not provide necessary equipment for their procedures and thus considered their services unreliable.
Practical implications
Reliability was perceived as a significant problem in this study; therefore, the hospitals management should ensure correct diagnoses and treatment results of the highest quality and timely services. Also, the management should invoke strong relationships between the employees and patients to earn patients’ trust. Employees should ensure to listen to patients’ complaints and find solutions promptly. Patients need health-care workers’ support and rely on their abilities; Therefore, health-care workers should be highly dependable and show empathic behaviour in discharging their duties. Health-care managers must access employees‘ and patients’ particular perceptual gaps and reconcile the difference before further quality improvement initiatives.
Originality/value
The findings in this study strengthen the clamour for assessing service quality from both employees and patients’ views in public hospitals. Hospital service quality is complex and primarily judged from the patients’ perspective. This study showed that health-care quality means different things to all stakeholders.
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Phurtag RD, Häckel S, Benneker LM, Liu KB, Albers CE, Ahmad SS, Deml MC. Gender authorship trends in spine research publications - Research across different countries from 1976 to 2020. BRAIN AND SPINE 2022; 2:100889. [PMID: 36248135 PMCID: PMC9560654 DOI: 10.1016/j.bas.2022.100889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 03/22/2022] [Accepted: 04/12/2022] [Indexed: 10/27/2022]
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Shen M, Li L, Wu Y, Yang Y. Comparison of inpatient spending and readmission rates for patients treated by male versus female physicians in China: An observational study. J Health Serv Res Policy 2021; 27:114-121. [PMID: 34971520 DOI: 10.1177/13558196211058974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine whether there are significant differences in costs of treatment and readmission rates for hospital consultations undertaken by female versus male physicians in China. METHODS Using data from the Urban Employee Basic Medical Insurance program from January 2018 through October 2019, we investigated spending patterns and clinical outcomes for patients at tertiary hospitals in one of the largest cities in China by the gender of the attending physician. Our sample included 79,085 hospitalizations treated by 3993 physicians in internal medicine departments. We examined the association between physician gender and visit cost using a multivariable linear model. We examined the association between physician gender and 30-days readmission rates using a multivariable probability model. We adjusted for a rich set of patient characteristics, primary diagnosis fixed effects, and hospital fixed effects. In addition, we used patient fixed effects in a robustness analysis. RESULTS Adjusting for primary diagnosis fixed effects, spending per visit was 4.1% higher for patients treated by male physicians than for those treated by female physicians, a statistically significant difference (95% CI [1.5%, 6.7%]). This pattern persisted after further adjusting for hospital fixed effects (3.2% [1.2%, 5.2%]), patient characteristics (3.2% [1.2%, 5.1%]), and patient fixed effects (4.2% [1.8%, 6.7%]). The difference is mainly driven by higher spending on drugs (8.7% [3.9%, 13.6%]) and out-of-pocket costs (3.9% [1.7%, 6.0%]). No statistically significant differences were observed in the readmission rates of patients treated by male and female physicians in any of our three model specifications. CONCLUSIONS Spending per visit was significantly higher among patients treated by male physicians than among those treated by female physicians, with the difference mainly driven by spending on drugs and out-of-pocket costs. No significant difference was observed in the hospital readmission rates of patients treated by male and female physicians. These findings have important implications for gender equality in medicine and health care quality and efficiency in developing countries.
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Affiliation(s)
- Menghan Shen
- Center for Chinese Public Administration Research, School of Government, 26469Sun Yat-sen University, Guangzhou, China, 510275
| | - Linyan Li
- Harvard TH Chan School of Public Health, Boston, MA, USA.,School of Data Science, 53025City University of Hong Kong, Kowloon, Hong Kong.,Department of Infectious Diseases and Public Health, Jockey Club College of Veterinary Medicine and Life Sciences, 53025City University of Hong Kong, Kowloon, Hong Kong
| | - Yushan Wu
- The Jockey Club School of Public Health and Primary Care, 26451Chinese University of Hong Kong, Hong Kong
| | - Yuanfan Yang
- Department of Pathology, School of Medicine, 12277Duke University, Durham, NC, USA
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Qin S, Ding Y. Who Is More Satisfied with Health Services? A Cross-Sectional Study in China. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2021; 58:46958021999926. [PMID: 33645255 PMCID: PMC7923977 DOI: 10.1177/0046958021999926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This cross-sectional study aims to assess the Chinese population’s satisfaction with health service and identify 2 types of variables, Andersen’s behavioral model related variables and social environment variables associated with high satisfaction. Data were derived from the 2013 Chinese General Social Survey (CGSS). Using exploratory factor analysis, the original questionnaire’s 10 health services were grouped into 2 dimensions, including “health management service” and “public health service.” Then, the satisfaction was described. The associations between satisfaction and factors were assessed using a multivariable logistic regression model. As a result, a total of 5283 subjects were enrolled. The satisfaction was 56.74% for “health management service” and 54.48% for “public health service.” Those with older age, lower education level, positive social environment factors (ie, higher perceived social class, higher perceived social trust, and perceived social equity), and having pension were more likely to report high satisfaction. Moreover, compared to the east region (the most prosperous region), the individuals from the central region or the north-east region (both regional economic levels were medium) had lower odds of reporting high satisfaction. In comparison, those from the west region (the least developed region) had higher odds. In conclusion, actionable measures to increase satisfaction should be proposed by the Chinese government, including increasing pension insurance coverage, increasing investment in health services, creating an excellent social environment, etc.
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Affiliation(s)
- Shangren Qin
- Hangzhou Normal University, Hangzhou, China.,Hangzhou Medical College, Hangzhou, China
| | - Ye Ding
- Hangzhou Medical College, Hangzhou, China
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Zou W, Zhang WJ, Tang L. What Do Social Media Influencers Say about Health? A Theory-Driven Content Analysis of Top Ten Health Influencers' Posts on Sina Weibo. JOURNAL OF HEALTH COMMUNICATION 2021; 26:1-11. [PMID: 33372857 DOI: 10.1080/10810730.2020.1865486] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Social media health influencers play an increasingly important role in disseminating health-related information to the public. To explore how health influencers in China communicate with their followers, we conducted a content analysis of the top ten health influencers' posts (n = 1000) on Sina Weibo guided by the Extended Parallel Processing Model (EPPM) and the transportation theory. These posts were coded in terms of demographic information, topics, message properties (informative, persuasive, and interactive), EPPM variables, and types of evidence (statistical and narrative) used. Results showed that these influencers had a clear emphasis on women's health (OB/GYN diseases and risks related to pregnancy and childcare) and beauty and skincare (in terms of risks and benefits). Overall, they used low fear appeal and high efficacy messages. However, messages containing efficacy information were less likely to be liked. These influencers relied heavily on narrative evidence; however, there was no significant relationship between the use of either narrative or statistical evidence and the number of likes. Differences in the communication strategies in posts about different diseases did exist but were not prevalent.
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Affiliation(s)
- Wenxue Zou
- Department of Communication, Texas A&M University, College Station, Texas, USA
| | - Wanjiang Jacob Zhang
- School of Journalism and Communication, The Chinese University of Hong Kong, Hong Kong, PR China
| | - Lu Tang
- Department of Communication, Texas A&M University, College Station, Texas, USA
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10
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AL-Mohaithef M, Almezaal EM, Elsayed EH, Javed N, Chandramohan S. Chronic disease patients' satisfaction with primary health-care services provided by the second health cluster in Riyadh, Saudi Arabia. SAUDI JOURNAL FOR HEALTH SCIENCES 2021. [DOI: 10.4103/sjhs.sjhs_213_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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11
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Aloudah N, Alhumsi A, Alobeid N, Aboheimed N, Aboheimed H, Aboheimed G. Factors impeding the supply of over-the-counter medications according to evidence-based practice: A mixed-methods study. PLoS One 2020; 15:e0240913. [PMID: 33211738 PMCID: PMC7676695 DOI: 10.1371/journal.pone.0240913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 10/05/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Despite the positive attitudes pharmacists have toward evidence-based practices (EBPs), its application in community pharmacies in Saudi Arabia is lacking. Therefore, this study aimed to explore and assess EBPs by community pharmacists in Saudi Arabia when they dispense over-the-counter (OTC) medications for three minor ailments: diarrhea, cough, and the common cold. RESEARCH DESIGN AND METHODS We used a mixed-methods approach consisting of two study parts. The first was a quantitative investigation that used mystery shoppers. Four researchers, posing as mystery shoppers, visited 214 randomly selected pharmacies in the Riyadh region of Saudi Arabia. They used 14 questions from a standardized checklist to examine EBPs by community pharmacists. The qualitative part of the study entailed three focus-group discussions with 13 pharmacists from different community practice settings and explored factors that affected the application of EBPs when supplying OTC medications from the pharmacists' point of view. RESULTS The analysis indicated that 40% of pharmacists dispensed OTC medications according to EBPs. Logistic regression analysis showed that one question, "Describe your symptoms", predicted the correct supply of OTC medications (p = 0.021). The qualitative section of the study identified nine factors that affected EBP. Some of these factors facilitated EBP, such as established patient-pharmacist relationships, some acted as barriers such as conflicts between available evidence, while other factors could either facilitate or hinder EBPs, such as the health literacy of the patient. CONCLUSION Given that dispensing OTC medication is a core function of pharmacists, this study uncovered low adherence to EBPs by community pharmacists in Saudi Arabia when dispensing OTC medication for three minor ailments: diarrhea, cough, and the common cold. Furthermore, this study identified a number of explanatory factors for this low adherence. Targeting these factors could help change the behavior of pharmacists and decrease undesirable outcomes.
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Affiliation(s)
- Nouf Aloudah
- Clinical Pharmacy Department, King Saud University, Riyadh, Saudi Arabia
| | - Areej Alhumsi
- Sales and Clinical Specialist Oncology, Becton Dickinson, Riyadh, Saudi Arabia
| | - Nada Alobeid
- Benefit Risk Assessment Department, Saudi Food and Drug Authority, Riyadh, Saudi Arabia
| | - Nourah Aboheimed
- Pharmacy Practice Department, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hind Aboheimed
- Pharmaceutical Care Services, King Abdulaziz Medical City-Riyadh, National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Ghada Aboheimed
- Clinical Pharmacy Department, King Saud University, Riyadh, Saudi Arabia
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Liu J, Mao Y. Patient Satisfaction with Rural Medical Services: A Cross-Sectional Survey in 11 Western Provinces in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203968. [PMID: 31627474 PMCID: PMC6843638 DOI: 10.3390/ijerph16203968] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/09/2019] [Accepted: 10/17/2019] [Indexed: 12/18/2022]
Abstract
Rural medical services play an important role in protecting and promoting the health of the rural population; however, patient satisfaction with rural medical services has been understudied in China. A better understanding of the actual situation and the determinants involved will provide evidence for health-related policy makers and hospital managers to further improve rural medical services. A total of 9811 patients (5208 outpatients and 4603 inpatients) were included in this study from a cross-sectional survey conducted in rural hospitals from 11 western provinces in China. Three in five patients (including outpatients and inpatients) were satisfied with rural medical services. The mean overall satisfaction scores were 3.61 ± 0.857 and 3.80 ± 0.829 (out of a maximum of 5) for rural outpatients and inpatients, respectively. The most satisfying domains for outpatients and inpatients were medical service attitude and illness explanation, and waiting time and medical expenses were the domains that outpatients and inpatients were least satisfied with. Satisfaction with medical technology (OR: 1.73; 95% CI: 1.57–1.92) and satisfaction with trust in physicians (OR: 2.05; 95% CI: 1.85–2.28) were identified as the strongest predictors of outpatients’ and inpatients’ overall satisfaction with rural medical services, respectively. This study might shed light on rural medical services management in China.
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Affiliation(s)
- Jinlin Liu
- Walter H. Shorenstein Asia-Pacific Research Center, Stanford University, Stanford, CA 94305, USA.
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi'an Jiaotong University, Xi'an 710049, China.
| | - Ying Mao
- Research Center for the Belt and Road Health Policy and Health Technology Assessment, Xi'an Jiaotong University, Xi'an 710049, China.
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China.
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Hay K, McDougal L, Percival V, Henry S, Klugman J, Wurie H, Raven J, Shabalala F, Fielding-Miller R, Dey A, Dehingia N, Morgan R, Atmavilas Y, Saggurti N, Yore J, Blokhina E, Huque R, Barasa E, Bhan N, Kharel C, Silverman JG, Raj A. Disrupting gender norms in health systems: making the case for change. Lancet 2019; 393:2535-2549. [PMID: 31155270 PMCID: PMC7233290 DOI: 10.1016/s0140-6736(19)30648-8] [Citation(s) in RCA: 131] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 03/06/2019] [Accepted: 03/11/2019] [Indexed: 12/21/2022]
Abstract
Restrictive gender norms and gender inequalities are replicated and reinforced in health systems, contributing to gender inequalities in health. In this Series paper, we explore how to address all three through recognition and then with disruptive solutions. We used intersectional feminist theory to guide our systematic reviews, qualitative case studies based on lived experiences, and quantitative analyses based on cross-sectional and evaluation research. We found that health systems reinforce patients' traditional gender roles and neglect gender inequalities in health, health system models and clinic-based programmes are rarely gender responsive, and women have less authority as health workers than men and are often devalued and abused. With regard to potential for disruption, we found that gender equality policies are associated with greater representation of female physicians, which in turn is associated with better health outcomes, but that gender parity is insufficient to achieve gender equality. We found that institutional support and respect of nurses improves quality of care, and that women's empowerment collectives can increase health-care access and provider responsiveness. We see promise from social movements in supporting women's reproductive rights and policies. Our findings suggest we must view gender as a fundamental factor that predetermines and shapes health systems and outcomes. Without addressing the role of restrictive gender norms and gender inequalities within and outside health systems, we will not reach our collective ambitions of universal health coverage and the Sustainable Development Goals. We propose action to systematically identify and address restrictive gender norms and gender inequalities in health systems.
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Affiliation(s)
| | - Lotus McDougal
- Center on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Valerie Percival
- Norman Paterson School of International Affairs, Carleton University, Ottawa, ON Canada
| | - Sarah Henry
- Department of Pediatrics, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Jeni Klugman
- Georgetown Institute for Women, Peace and Security, Georgetown University, Washington, DC, USA; Women and Public Policy Program, Harvard Kennedy School, Cambridge, MA, USA
| | - Haja Wurie
- College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
| | - Joanna Raven
- Liverpool School of Tropical Medicine, Liverpool, UK
| | | | - Rebecca Fielding-Miller
- Center on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Arnab Dey
- Sambodhi Research & Communications, Noida, Uttar Pradesh, India
| | | | - Rosemary Morgan
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
| | | | | | - Jennifer Yore
- Center on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Elena Blokhina
- Vladman Institute of Pharmacology, Department of Psychiatry, First Pavlov State Medical University of St Petersburg, Saint Petersburg, Russia
| | | | - Edwine Barasa
- Kemri-Wellcome Trust, Kenya Research Programme, Nairobi, Kenya
| | - Nandita Bhan
- Center on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | | | - Jay G Silverman
- Center on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Anita Raj
- Center on Gender Equity and Health, Department of Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA.
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Leggat SG, Liu C, Wu Q. Sino-Australian University Partnership in Health Management Education. Front Public Health 2018; 6:251. [PMID: 30246005 PMCID: PMC6137234 DOI: 10.3389/fpubh.2018.00251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Accepted: 08/15/2018] [Indexed: 02/03/2023] Open
Abstract
This paper outlines a successful partnership program between La Trobe University in Melbourne Australia, and Harbin Medical University in Harbin, China. These two universities have been collaborating for more than 15 years to provide a comprehensive Master of Health Administration program that adapts the Australian curriculum to meet the rapidly increasing need for qualified health services managers throughout China. This paper describes the mechanisms by which the joint programs were developed and how the two universities work together in partnership to continually improve the program components and outcomes, taking into account the significant differences in context and cultures. Since 2001, La Trobe University has enrolled about 1000 Chinese health services managers, with 721 completing a Master's degree, who are now having increasing influence on the reforms of the Chinese health care system. The partnership has enriched Australian knowledge of Chinese culture and values, as well as the Chinese health system and health policies, as evidenced by the large volume of joint publications. The profession of health management has been substantially strengthened in China, and working together, Chinese and Australian academics have had demonstrated impact on enhancing the reforms of the Chinese public health system. Further studies, with sufficient funds for data collection, are needed to evaluate the long-term impacts of transnational programs on academic and health system development in China.
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Affiliation(s)
- Sandra G. Leggat
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | - Chaojie Liu
- Department of Public Health, School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, China
- *Correspondence: Chaojie Liu
| | - Qunhong Wu
- Department of Social Medicine, School of Public Health, Harbin Medical University, Harbin, China
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