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.
Highlights
China launched an ambitious national health reform plan in 2009 with the aim of providing universal coverage of essential health services that are safe, effective, accessible, and affordable for all Chinese citizens by 2020 [1]
Demographic characteristics, self-rated health, and chronic conditions of the total 14,813 respondents are reported in Table 1 along with the characteristics of the 1014 rural public clinic users included in our analysis
Using a national representative sample of public clinic users in rural China, we found that treatment outcome was a stronger predictor of overall satisfaction with primary care than interpersonal care aspects
Summary
China launched an ambitious national health reform plan in 2009 with the aim of providing universal coverage of essential health services that are safe, effective, accessible, and affordable for all Chinese citizens by 2020 [1]. With a start-up investment of USD 125 billion, this health reform reaffirmed the government’s central role in financing health care services, which focused on strengthening the primary care system, establishing a national essential medicines system, expanding health insurance coverage, providing public health services, and conducting public hospital reform [2,3]. Notable progress has been achieved since . The population coverage of social health insurance schemes increased to more than 97% in 2015, and the share of the out-of-pocket. Res. Public Health 2019, 16, 697; doi:10.3390/ijerph16050697 www.mdpi.com/journal/ijerph
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