Evaluation of medical staff and patient satisfaction of Chinese hospitals and measures for improvement

Patient satisfaction and their determinants in outpatient department of a tertiary public hospital in Nepal: a cross-sectional study

BACKGROUND

Patient satisfaction is a vital metric for assessing healthcare quality and delivering patient-centered care. It can predict service utilization patterns by determining healthcare users' contentment with their providers. Consequently, evaluating patient satisfaction and its underlying factors is crucial to maintaining the quality of healthcare services. The present study aimed to assess patient satisfaction and its determinants in a tertiary care public hospital in Nepal. In this research, a cross-sectional design was employed to examine patient satisfaction within the Outpatient Department of Mental Hospital Lagankhel, Nepal. The study adopted a systematic random sampling approach for respondent selection, and stringent measures were implemented to uphold the validity and reliability of the collected data. To assess patient satisfaction comprehensively, the Patient Satisfaction Questionnaire-III (PSQ-III), developed by the RAND Corporation, was employed in conjunction with relevant sociodemographic variables. Utilizing mean scores and percentages, we calculated satisfaction levels across various dimensions. Additionally, a multinomial logistic regression analysis was conducted to investigate the relationships between patient satisfaction dimensions and sociodemographic characteristics.

RESULTS

This study encompassed perspective of 206 participants, with 57.3% representing patient relatives and 51% being male, median age of 32 years (standard deviation: 12.53). Notably, patients reported higher levels of satisfaction, particularly within the interpersonal relationship dimension, while the technical quality domain received comparatively lower satisfaction ratings. Multinomial logistic regression analysis underscored the significance of sociodemographic factors in shaping patient satisfaction, with age (p = 0.008), type of residence (p = 0.001), occupation (p = 0.0019), income status (p = 0.014), time to reach the healthcare facility (p = 0.013), and insurance enrollment status (p = 0.017) all demonstrating significant associations. These findings illuminate the intricate qualities of patient satisfaction within our healthcare context, offering actionable insights for enhancement and guiding the trajectory of future research endeavors.

CONCLUSIONS

Overall patient expressed satisfaction with service provided by tertiary care hospital, however continuous improvement remains essential. Conducting large-scale, nationwide studies across hospital tiers is vital. This data-driven approach empowers policymakers to allocate resources effectively, inform decision-making, and enact policies that exceed patient expectations, fostering a healthcare system of unparalleled excellence.

Influencing Factors of Outpatients' Satisfaction in China a Cross-Sectional Study of 16 Public Tertiary Hospitals

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.

Effective Analysis of Inpatient Satisfaction: The Random Forest Algorithm

PURPOSE

To identify the factors influencing inpatient satisfaction by fitting the optimal discriminant model.

PATIENTS AND METHODS

A cross-sectional survey of inpatient satisfaction was conducted with 3888 patients in 16 large public hospitals in Zhejiang Province. Independent variables were screened by single-factor analysis, and the importance of all variables was comprehensively evaluated. The relationship between patients' overall satisfaction and influencing factors was established, the relative risk was evaluated by marginal benefit, and the optimal model was fitted using the receiver operating characteristic curve.

RESULTS

Patients' overall satisfaction was 79.73%. The five most influential factors on inpatient satisfaction, in this order, were: patients' right to know, timely nursing response, satisfaction with medical staff service, integrity of medical staff, and accuracy of diagnosis. The prediction accuracy of the random forest model was higher than that of the multiple logistic regression and naive Bayesian models.

CONCLUSION

Inpatient satisfaction is related to healthcare quality, diagnosis, and treatment process. Rapid identification and active improvement of the factors affecting patient satisfaction can reduce public hospital operating costs and improve patient experiences and the efficiency of health resource allocation. Public hospitals should strengthen the exchange of medical information between doctors and patients, shorten waiting time, and improve the level of medical technology, service attitude, and transparency of information disclosure.

Awareness of the role of general practitioners in primary care among outpatient populations: evidence from a cross-sectional survey of tertiary hospitals in China

OBJECTIVE

General practitioners (GPs) are highly underutilised in China with many patients going directly to hospitals when seeking routine care. Multiple countries around the world have successfully used GPs in routine care, and as such, China may benefit from the use of GPs. This study examines the status of, and factors associated with, knowledge related to GPs among outpatient populations from China's tertiary hospitals.

DESIGN

This is a cross-sectional survey study.

STUDY SETTING AND PARTICIPANTS

The questionnaires were completed by 565 outpatients from four tertiary hospitals in China during 2016. Convenience sampling on different floors and throughout the outpatient building was carried out.

PRIMARY OUTCOME MEASURES

We used the logistic regression models to identify GP-related knowledge among different populations.

RESULTS

Overall, 50.27% of respondents said they had never heard of GPs. This was also true among females (adjusted OR (AOR)=1.57, 95% CI 1.43 to 2.71), older adults (AOR_46-65=1.61, 95% CI 1.39 to 2.98; AOR_>65=2.01, 95% CI 1.62 to 3.59), those with lower education level (AOR_{Bachelor's degree}=0.61, 95% CI 0.20 to 0.81; AOR_{≥Master's degree}=0.49, 95% CI 0.23 to 0.76), rural residents (AOR=1.51, 95% CI 1.35 to 2.82) and those with chronic disease (AOR_{without chronic disease}=0.61, 95% CI 0.22 to 0.71). What is more, less than one-in-ten (9.03%) outpatients were able to accurately describe what a GP was, with less than 30% accurately describing a GP among those receiving GPs' services.

CONCLUSIONS

Outpatients who could have received less costly health services from GPs in primary medical institutions were more likely to choose costlier specialist physicians in tertiary hospitals, which is likely linked to limited knowledge about GPs. Policy makers should invest in outreach efforts to improve public awareness of GPs, while at the same time conducting continued surveillance of these efforts to evaluate progress towards this goal.

Factors affecting patient satisfaction with ecdemic medical care: a cross-sectional study in Nanchang, China

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.

Medical humanities play an important role in improving the doctor-patient relationship

Doctors in China have been wounded or even killed in frequent violence as conflict between doctors and patients has intensified. China has had a massive dearth of medical students over the past decade and doctors are dissatisfied with conditions in their profession. Conditions in medicine are not conducive to medical reform. This paper notes that the main factors affecting the doctor-patient relationship are a lack of humanity in medicine, the predominance of techniques and technologies, and inappropriate administration of hospitals. These factors are related to a lack of medical humanities. This paper describes several steps to make medicine more humane and to help establish a harmonious doctor-patient relationship, including improved humanities education for doctors and medical students, ending the predominance of techniques and technologies, bringing back "humanity" in medicine, and improving the administration of hospitals.

Continuing violence against medical personnel in China: A flagrant violation of Chinese law

Over the past few years, China has witnessed a surge in violence against medical personnel, including widely reported incidents of violent abuse, riots, attacks, and protests in hospitals, where doctors suffer from heavy workloads and little protection. China has engaged in serious efforts, such as investing large amounts into the healthcare system and implementing several decades of healthcare reform, to make medical care more accessible to and affordable for the public. However, incidents of violence against medical personnel have increased in intensity, reflecting deteriorating relations between medical staff and their patients in China over the past few decades. Hence, the effectiveness of healthcare legislation needs to be examined and medical reform and development of the healthcare system need to be reevaluated. Only by enhancing oversight, promoting healthcare reform, and improving the healthcare system can we repair the doctor-patient relationship and decrease violence against doctors in China.