1
|
Nguyen BQ, Nguyen CTT. An Assessment of Outpatient Satisfaction with Hospital Pharmacy Quality and Influential Factors in the Context of the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:healthcare10101945. [PMID: 36292392 PMCID: PMC9601799 DOI: 10.3390/healthcare10101945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/25/2022] [Accepted: 09/30/2022] [Indexed: 11/04/2022] Open
Abstract
The study aims to evaluate outpatient satisfaction (OS) with health insurance drug dispensing at the central hospital in Vietnam and to explore the influential factors. A cross-sectional survey was conducted on adult outpatients via an adjusted SERVQUAL questionnaire. The questionnaire's internal consistency (Cronbach alpha) and construct validity (exploratory factor analysis) were considered. The difference between groups was solved using a t-test or ANOVA-test. The multiple-regression analysis determined the influence levels of each factor. A p-value less than 0.05 was statistically significant. A total of 210 participants participated, with most being over 55 years old, female, with a high school education, and freelancers. The mean general satisfaction score was 3.42 (SD = 0.79). The reliability obtained the highest satisfaction score, and the guarantee was the lowest. The final questionnaire, including five factors (reliability, responsiveness, assurance, sympathy, and tangible) with 26 observational variables, had an internal consistency reliability and construct validity. These five factors had a statistically significant correlation and influence on the general satisfaction of the outpatients. The reliability factor had the strongest influence, and assurance had the weakest. Training staff about communication, counseling, and consolidating the facilities are the core solutions for increasing OS.
Collapse
Affiliation(s)
- Binh Quoc Nguyen
- Pharmacy Department, Cho Ray Hospital, Ho Chi Minh City 700000, Vietnam
| | - Cuc Thi Thu Nguyen
- Faculty of Pharmaceutical Management and Economics, Hanoi University of Pharmacy, Hanoi City 100000, Vietnam
- Correspondence:
| |
Collapse
|
2
|
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: 4] [Impact Index Per Article: 2.0] [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
|
3
|
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
|
4
|
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
|
5
|
Factors Associated with Outpatient Satisfaction in Tertiary Hospitals in China: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197070. [PMID: 32992600 PMCID: PMC7579147 DOI: 10.3390/ijerph17197070] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 09/20/2020] [Accepted: 09/26/2020] [Indexed: 12/30/2022]
Abstract
Outpatient care is made up of medical procedures, tests, and services that can be provided to the patient in a setting that doesn’t involve an overnight hospital stay. In China, tertiary hospitals are medical services centers of health care systems, and some tertiary hospitals had more than 20,000 outpatient visits per day. However, a systematic review of existed evidence on factors influencing the outpatient satisfaction in tertiary hospitals in China could inform the efforts and does not yet exist. Therefore, in order to better understand the outpatient satisfaction provided by tertiary hospitals in China, we carried out a systematic review following PRISMA guidelines. Studies reporting on the level of and factors associated with outpatient satisfaction in Chinese tertiary hospitals were systematically searched in both Chinese and English electronic databases. A total of 36 articles reported 35 studies that met the inclusion criteria. Out of these eight were household surveys covering 12,119 residents, and another 27 directly interviewed 45,930 outpatients during their hospital visits from 185 hospitals. The included studies generally used self-designed questionnaire and indicated there is a lack of standardized questionnaire for investigating outpatient satisfaction in China. The outpatients showed the highest satisfaction with the doctors and nurses and the lowest satisfaction with the hospital hygiene and outpatient procedures, especially with the long waiting time. The socio-demographic characteristics (e.g., age, marital status, income and education levels), professional skills and service attitudes of medical staff were reported to be associated with outpatient satisfaction. The results indicated that in China, the outpatient satisfaction can be largely improved. Firstly, the attitude of medical service providers, especially the pre-diagnosis nurses, registration officers, and pharmaceutical counters should be improved. Furthermore, to shorten the waiting time, policies should be developed to guide patients with common diseases and slight discomforts to community health systems to alleviate the overload in tertiary hospitals. Considering the strained relations between the doctors and patients in the clinical practice, improving patient satisfaction in China deserves more attention and research.
Collapse
|
6
|
Zhang H, Wang W, Haggerty J, Schuster T. Predictors of patient satisfaction and outpatient health services in China: evidence from the WHO SAGE survey. Fam Pract 2020; 37:465-472. [PMID: 32064515 PMCID: PMC7474531 DOI: 10.1093/fampra/cmaa011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Patient satisfaction is an essential indicator in medical practise and research. To monitor the health and well-being of adult populations and the ageing process, the World Health Organization (WHO) has initiated the Study on Global AGEing and Adult Health (SAGE), compiling longitudinal information in six countries including China as one major data source. OBJECTIVE The objective of this study was to identify potential predictors for patient satisfaction based on the 2007-10 WHO SAGE China survey. METHODS Data were analysed using random forests (RFs) and ordinal logistic regression models based on 5774 responses to predict overall patient satisfaction on their most recent outpatient health services visit over the last 12 months. Potential predictor variables included access to care, costs of care, quality of care, socio-demographic and health care characteristics and health service features. Increase of the mean-squared error (incMSE) due to variable removal was used to assess relative importance of the model variables for accurately predicting patient satisfaction. RESULTS The survey data suggest low frequency of dissatisfaction with outpatient services in China (1.8%). Self-reported treatment outcome of the respective visit of a care facility demonstrated to be the strongest predictor for patient satisfaction (incMSE +15%), followed by patient-rated communication (incMSE +2.0%), and then income, waiting time, residency and patient age. Individual patient satisfaction in the survey population was predicted with 74% accuracy using either logistic regression or RF. CONCLUSIONS Patients' perceived outcomes of health care visits and patient communication with health care professionals are the most important variables associated with patient satisfaction in outpatient health services settings in China.
Collapse
Affiliation(s)
- Hao Zhang
- Department of Family Medicine, McGill University, Montréal, Canada
| | - Wenhua Wang
- Department of Family Medicine, McGill University, Montréal, Canada
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, Montréal, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill University, Montréal, Canada
| |
Collapse
|
7
|
Hu L, Ding H, Hu G, Wang Z, Liu S, Liu Y. How Perceived Quality of Care Affects Outpatient Satisfaction in China: A Cross-Sectional Study of 136 Tertiary Hospitals. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2020; 56:46958019895397. [PMID: 31884866 PMCID: PMC6937535 DOI: 10.1177/0046958019895397] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Public hospitals are integral components of China’s health care system, and improving quality of care and patient satisfaction has become of greater concern for these hospitals. The aim of this study was to assess outpatient satisfaction with tertiary hospitals and to explore the roles played by patient perceptions of specific aspects of care in overall satisfaction. We designed a questionnaire to assess patient satisfaction and perceived quality of care using a 5-point Likert scale. The survey was conducted in 136 hospitals across 31 provinces of China, and a total of 28 822 patients were interviewed. For statistical analysis, we conducted descriptive analysis, nonparameter tests, Spearman’s rank correlation, and multivariate logistic regression. Stepwise logistic regression identified 12 variables of patient perception associated with overall satisfaction. Patients’ perception of physicians’ technical skills had the strongest association with satisfaction, followed by inquiries into medical history/current situation and availability of elevators. Other determinants included a feeling of respect, timely guidance when needed, and explanation of treatments and medications. Waiting times and hospital environment factors, such as cleanliness of bathrooms and drinking water supply, were also associated with patient satisfaction in a slightly less powerful way. This study revealed that Chinese outpatient satisfaction with tertiary hospitals was relatively high. As determinants of satisfaction, patients valued professional medical care and respect from the medical staff more than nonmedical aspects of care. This implied that Chinese hospitals should ensure quality of medical care and sufficient communication with patients, as well as pay more attention to humanism in health care. In the meantime, improvements should be made to nonmedical aspects of care, especially waiting times and physical environment. These findings are also useful for the rest of the low- and middle-income world in improving patient satisfaction.
Collapse
Affiliation(s)
- Linlin Hu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | | | - Guangyu Hu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | - Zijuan Wang
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | - Shiyang Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| | - Yuanli Liu
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China
| |
Collapse
|
8
|
Chen J, Xu S, Gao J. The Mixed Effect of China's New Health Care Reform on Health Insurance Coverage and the Efficiency of Health Service Utilisation: A Longitudinal Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1782. [PMID: 32182950 PMCID: PMC7084895 DOI: 10.3390/ijerph17051782] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 11/17/2022]
Abstract
In 2009, China launched a new health care reform as it endeavoured to develop a tiered system of disease diagnosis and treatment to promote the integration of medical resources. This was important for improving service capacity and building medical alliances that would eventually lead to improved health service utilisation efficiency. However, while the 2009 reform aimed to provide universal health insurance coverage to all citizens, its overall effect on health service utilisation efficiency remains unclear. We aimed to examine the new health care reform's mixed effect by applying a longitudinal study using China Health and Nutrition Survey (CHNS) data and the difference-in-difference (DID) method to estimate the health reform's impact on health insurance coverage rate. Then, we studied whether the increase in health insurance coverage rate affected health service utilisation efficiency in China. Our results showed that the increase in insurance coverage rate has indeed made expensive medical services available to low-income individuals. However, it also increased the likelihood of use of hospitals rather than primary care facilities, since there is more insurance cover for outpatient visits, which has led to an increased demand for quality services. This effect has generated a negative impact on health care utilisation which directly pertains to systemic inefficiency. This study thus indicates that China's latest health reform requires further policies to improve its overall efficiency.
Collapse
Affiliation(s)
- Jiaqi Chen
- School of Business, Jiangnan University, 1800 Lihu Ave, Binhu District, Wuxi 214122, China; (J.C.); (J.G.)
| | - Song Xu
- School of Medicine, Jiangnan University, 1800 Lihu Ave, Binhu District, Wuxi 214122, China
| | - Jing Gao
- School of Business, Jiangnan University, 1800 Lihu Ave, Binhu District, Wuxi 214122, China; (J.C.); (J.G.)
| |
Collapse
|
9
|
Ke L, Chen J, Jia J, Ke P, Chen X, Mao Z, Liu B. Outpatients' Satisfaction in the Context of 10 Years of Health-Care Reform: A Cross-Sectional Study of Tertiary Hospitals in Shiyan, China. Patient Prefer Adherence 2020; 14:191-202. [PMID: 32099337 PMCID: PMC6996206 DOI: 10.2147/ppa.s233472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/13/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE This study aimed to evaluate outpatient satisfaction in tertiary hospitals in Shiyan, China, to predict which items had highest priorities for outpatient satisfaction, and to identify population groups on which the medical institutions should focus. PATIENTS AND METHODS A cross-sectional survey was conducted at three tertiary hospitals in Shiyan city of China, from March to June 2018. An 18-item outpatient satisfaction questionnaire was applied. We conducted matrix analysis to describe the distribution of satisfaction score and the degree of influence of the items. Outpatient satisfaction was classified into the lowest and highest groups according to the 80/20 rule. Logistic regression model was used to identify demographic factors which might influence outpatient satisfaction. RESULTS A total of 2109 valid questionnaires were completed. The "waiting time", "diagnosis and treatment time" and "medical charges" items showed relatively higher degrees of influence but earned lower levels of satisfaction. Outpatients with a college level or above educational background (AOR=1.36, 95% CI=1.03-1.79) and with a family per-capita monthly income (FPMI)>7000 CNY (AOR=3.30, 95% CI=1.60-6.81) were more prevalent in the lowest satisfaction group. Outpatients with college level or above education background (COR=0.77, 95% CI=0.60-0.99), FPMI of 3001-5000 CNY (AOR=0.76, 95% CI=0.60-0.96), non-local residents (AOR=1.48, 95% CI=1.07-2.04), and urban workers with medical insurance (AOR=1.74, 95% CI=1.27-2.39) were more prevalent in the highest satisfaction group. CONCLUSION The survey indicated that "long time to wait for treatment", "short treatment time", and "medical charges too expensive" were the top three aspects that need to be improved with priority by medical institutions. Education level, income level, residence and type of health insurance were the sociodemographic characteristics that significantly affect the outpatient satisfaction in tertiary hospitals. These factors need to be paid more attention by healthcare professionals to improve the patients' satisfaction.
Collapse
Affiliation(s)
- Li Ke
- School of Nursing, Hubei University of Medicine, Shiyan, People’s Republic of China
- Global Health Institute, Wuhan University, Wuhan, People’s Republic of China
| | - Jingshu Chen
- School of Public Health and Management, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Jia Jia
- School of Nursing, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Pan Ke
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Xueqin Chen
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, People’s Republic of China
| | - Zongfu Mao
- Global Health Institute, Wuhan University, Wuhan, People’s Republic of China
| | - Bing Liu
- School of Public Health and Management, Hubei University of Medicine, Shiyan, People’s Republic of China
- Center of Health Administration and Development Studies, Hubei University of Medicine, Shiyan, People’s Republic of China
| |
Collapse
|
10
|
Hu L, Zhou BP, Liu S, Wang Z, Liu Y. Outpatient Satisfaction with Tertiary Hospitals in China: The Role of Sociodemographic Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193518. [PMID: 31547189 PMCID: PMC6801474 DOI: 10.3390/ijerph16193518] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/13/2019] [Accepted: 09/18/2019] [Indexed: 12/16/2022]
Abstract
China’s increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process management and affordability domains, while high-income and high-education outpatients reported lower satisfaction scores in the hospital environment domain. Furthermore, migrant patients experienced lower satisfaction across several domains. These intricate findings suggest that hospitals should tailor their services and evaluation metrics to specific patient demographics, and that the government should adopt policies that reduce disparities in healthcare access and affordability to ultimately improve the satisfaction of vulnerable groups.
Collapse
Affiliation(s)
- Linlin Hu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
| | - Bright P Zhou
- Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA.
| | - Shiyang Liu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
| | - Zijuan Wang
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
| |
Collapse
|
11
|
Evaluating Primary Health Care Performance from User Perspective in China: Review of Survey Instruments and Implementation Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060926. [PMID: 30875833 PMCID: PMC6466226 DOI: 10.3390/ijerph16060926] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 03/04/2019] [Accepted: 03/11/2019] [Indexed: 12/28/2022]
Abstract
This review aims to summarize the progress of patient evaluation studies focusing on primary health care (PHC) in China, specifically in relation to survey instruments and implementation issues. Eligible studies published in English or Chinese were obtained through online searches of PubMed and China National Knowledge Infrastructure. A descriptive reporting approach was used due to variations in the measurements and administration methods between studies. A total of 471 articles were identified and of these articles; of those 91 full-text articles were included in the final analysis. Most studies used author-developed measurements with five-point Likert response scales and many used the Chinese translations of validated tools from other countries. Most instruments assessed the physical environment, medical equipment, clinical competency and convenience aspects of PHC using a satisfaction rating instead of care experience reporting. Many studies did not report the sampling approach, patient recruitment procedures and survey administration modes. The patient exit survey was the most commonly used survey implementation method. The focus on the structural dimensions of PHC, inconsistent wording, categories of response options that use satisfaction rating, and unclear survey implementation processes are common problems in patient evaluation studies of PHC in China. Further studies are necessary to identify population preferences of PHC in China in order to move towards developing Chinese value-based patient experience measurements.
Collapse
|
12
|
Wang W, Maitland E, Nicholas S, Haggerty J. Determinants of Overall Satisfaction with Public Clinics in Rural China: Interpersonal Care Quality and Treatment Outcome. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16050697. [PMID: 30818750 PMCID: PMC6427360 DOI: 10.3390/ijerph16050697] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/08/2019] [Accepted: 02/22/2019] [Indexed: 01/17/2023]
Abstract
The primary health care quality factors determining patient satisfaction will shape patient-centered health reform in China. While rural public clinics performed better than hospitals and private clinics in terms of patient perceived quality of primary care in China, there is little information about which quality care aspects drove patients’ satisfaction. Using a World Health Organization database on 1014 rural public clinic users from eight provinces in China, our multiple linear regression model estimated the association between patient perceived quality aspects, one treatment outcome, and overall primary health care satisfaction. Our results show that treatment outcome was the strongest predictor of overall satisfaction (β = 0.338 (95% CI: 0.284 to 0.392); p < 0.001), followed by two interpersonal care quality aspects, Dignity (being treated respectfully) (β = 0.219 (95% CI: 0.117 to 0.320); p < 0.001) and Communication (clear explanation by the physician) (β = 0.103 (95% CI: 0.003 to 0.203); p = 0.043). Prompt attention (waiting time before seeing the doctor) and Confidentiality (talking privately to the provider) were not correlated with overall satisfaction. The treatment outcome focus, and weak interpersonal primary care aspects, in overall patient satisfaction, pose barriers towards a patient-centered transformation of China’s primary care rural clinics, but support the focus of improving the clinical competency of rural primary care workers.
Collapse
Affiliation(s)
- Wenhua Wang
- Department of Family Medicine, McGill University, Montreal, QC H3T 1M5, Canada.
| | - Elizabeth Maitland
- University of Liverpool Management School, University of Liverpool, Liverpool L697ZH, UK.
| | - Stephen Nicholas
- School of Management and School of Commerce, Tianjin Normal University, Tianjin 300074, China.
- Guangdong Research Institute for International Strategies, Guangdong University of Foreign Studies, Guangzhou 510420, China.
- TOP Education Institute, Sydney, NSW 2015, Australia.
- University of Newcastle Business School, Newcastle, NSW 2308, Australia.
| | - Jeannie Haggerty
- Department of Family Medicine, McGill University, Montreal, QC H3T 1M5, Canada.
| |
Collapse
|
13
|
He X, Li L, Bian Y. Satisfaction survey among primary health care outpatients in the backward region: an empirical study from rural Western China. Patient Prefer Adherence 2018; 12:1989-1996. [PMID: 30323568 PMCID: PMC6173270 DOI: 10.2147/ppa.s172021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND With a growing health demand, patient satisfaction analysis is essential for evaluating the accessibility and performance of medical services. Previous studies had explored the Chinese outpatient satisfaction and influencing factors in developed areas and tertiary hospitals. Considering the lower education level, less income, and heavier economic burden, it was necessary to conduct a region-specific questionnaire survey for the outpatient's satisfaction in rural Western China. OBJECTIVE To analyze the satisfaction of primary outpatient service in rural Western China, and explore the factors affecting outpatients' satisfaction. METHODS Questionnaire composed of nine 5-Likert items was applied to survey outpatient satisfaction among randomly selected samples in 11 provinces of Western China. Exploratory factor analysis (EFA) was conducted to study the factor structure of questionnaire. Stepwise multiple linear regression analysis was performed to study the influencing factors. RESULTS A total of 2,754 outpatients completed the questionnaire, the response rate was 88.7%. Respondents were most satisfied with medical staff service attitude (3.71±0.83) and least satisfied with medical cost (2.97±0.83). A 3-factor solution was adopted in EFA to explain the overall satisfaction. Factors identified were "Service attitude", "Facility and professional skills", and "Patients' cost". And, the questionnaire was proved to have good reliability and acceptable internal consistency. The stepwise multiple linear regression analysis results presented that factors, including sample hospital type (P<0.05), age (P<0.001), education level (P<0.05), occupation (P<0.01), monthly income (P<0.05), and chronic disease conditions (P<0.01) were significantly associated with the dimensional or overall satisfaction. CONCLUSION The primary health care outpatient satisfaction in rural Western China is lower than developed areas and tertiary hospitals. Care providers in backward regions should pay more attention to patients' demographic characteristics and health status, to meet outpatients' actual demand. Efficient hospital management methods, modern technology, and staff training are needed to improve the service quality and care efficiency.
Collapse
Affiliation(s)
- Xin He
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China,
| | - Lingui Li
- School of Public Health and Management, Ningxia Medical University, Yinchuan, China
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau SAR, China,
| |
Collapse
|
14
|
Liu X, Lu H, Wang Y, Wang W, Hou Z, Tan A, Mao Z. Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China. Patient Prefer Adherence 2018; 12:1373-1382. [PMID: 30104864 PMCID: PMC6071645 DOI: 10.2147/ppa.s167244] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
PURPOSE This study aimed to determine the factors that influence patient satisfaction with ecdemic medical care. MATERIALS AND METHODS Eight hundred and forty-four face-to-face interviews were conducted between October and November 2017 in two high-profile hospitals in Nanchang, China. Patient satisfaction was divided into lowest and highest satisfaction groups according the 80/20 rule. Demographic factors associated with patient satisfaction were identified by logistic regression models. RESULTS Respondents' main reasons for choosing a non-local hospital were "high level of medical treatment" (581/844), "good reputation of the hospital" (533/844), and "advanced medical equipment" (417/844). The top three items that dissatisfied the ecdemic patients were "long time to wait for treatment" (553/844), "complicated formalities" (307/844), and "poor overall service attitude" (288/844). Fewer female patients (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.03-2.11), patients with a family per-capita monthly income (FPMI) between 3,001 and 5,000 CNY (AOR =1.40, 95% CI =1.01-2.17), inpatients (AOR =1.46, 95% CI =1.01-2.13), and more patients with an FPMI >7,000 CNY (AOR =0.43, 95% CI =0.20-0.92) were detected in the lowest satisfaction group. Fewer patients with an associate's or bachelor's degree (AOR =2.40, 95% CI =1.37-4.20) and patients with an FPMI >7,000 CNY (AOR =3.02, 95% CI =1.10-8.33) were detected in the highest satisfaction group. Moreover, more inpatients (AOR =0.70, 95% CI =0.54-0.97) and those aged 46-65 years (AOR =0.63, 95% CI =0.33-0.98) were detected in the highest satisfaction group. CONCLUSION Findings suggested that managers of the medical facilities should note the importance of increasing their publicity through a rapidly developing media, as well as the necessity of creating a more patient-friendly medical care experience. Hospitals should also focus on the medical care experience of patients with relatively lower and higher income levels, male ecdemic patients, and ecdemic outpatients.
Collapse
Affiliation(s)
- Xiaojun Liu
- School of Health Sciences, Wuhan University, Wuhan, China,
- Global Health Institute, Wuhan University, Wuhan, China,
| | - Hanson Lu
- University of Chicago, Chicago, IL, USA
| | - Yanan Wang
- School of Health Sciences, Wuhan University, Wuhan, China,
| | - Wenjie Wang
- School of Health Sciences, Wuhan University, Wuhan, China,
| | - Zhaoxun Hou
- School of Health Sciences, Wuhan University, Wuhan, China,
| | - Anran Tan
- Global Health Institute, Wuhan University, Wuhan, China,
- Global Health Research Center, Duke Kunshan University, Kunshan, China
| | - Zongfu Mao
- School of Health Sciences, Wuhan University, Wuhan, China,
- Global Health Institute, Wuhan University, Wuhan, China,
| |
Collapse
|
15
|
Pictograms to Provide a Better Understanding of Gastroesophageal Reflux Symptoms in Chinese Subjects. Gastroenterol Res Pract 2017; 2017:1214584. [PMID: 28656044 PMCID: PMC5471582 DOI: 10.1155/2017/1214584] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/02/2017] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To explore whether pictograms could help people understand reflux symptoms. METHODS Gastroenterologists (n = 28), non-GI physicians (n = 30), healthy people without medical education (n = 34), patients with gastrointestinal reflux disease (GERD) (n = 45), and general people (n = 100) were included. Pictograms denoting classic reflux symptoms (sour regurgitation, heartburn, retrosternal pain, and regurgitation) were created by the joint efforts of an artist and a gastroenterologist. The subjects were asked to tell the meaning of each card within 30 s. RESULTS Compared with the physicians, healthy people without medical education tended to make mistakes in the understanding of the terms of reflux symptoms. Among GERD patients, all the terms of reflux symptoms could be understood accurately. Compared with that of non-GI physicians, GI physician had a higher accuracy in the understanding of the term regurgitation (P < 0.05). Pictograms denoting reflux symptoms could be understood accurately in all four groups. A sample from the general population showed that the recognition of the pictogram was more accurate than the recognition of the terms. CONCLUSIONS Pictograms could help ordinary people who do not have medical education to understand reflux symptoms more accurately in China. Compared with abstract terms, pictograms could be useful for epidemiological studies and diagnosis of GERD in the community.
Collapse
|