Abstract
BackgroundIn rural areas of China, hypertension is on the rise and it is drawing the Chinese government’s attention. The health outcomes of hypertension management can be positively impacted by patient satisfaction with primary care physicians (PCPs), and the influence of patient trust on satisfaction cannot be ignored. This study aimed to analyze the effect of trust in PCPs on patient satisfaction among patients with hypertension in rural China, and the influence of patients’ socio-demographic characteristics and hypertension-management-related factors.MethodsA multi-stage stratified random sampling method was adopted to investigate 2665 patients with hypertension in rural China. Patient trust and satisfaction were measured using the Chinese version of the Wake Forest Physician Trust Scale and the European Task Force on Patient Evaluation of General Practice. Multiple linear regression was used to analyze the factors influencing patient satisfaction, and structural equation modeling was conducted to clarify the relationships among patient trust and patient satisfaction with PCPs.ResultsPatients’ trust in their PCPs’ benevolence had a positive main effect on all three satisfaction dimensions (clinical behavior: β = 0.940, p < 0.01; continuity and cooperation: β = 0.910, p < 0.01; and organization of care: β = 0.879, p < 0.01). Patients’ trust in their PCPs’ technical competence had a small negative effect on all three satisfaction dimensions (clinical behavior: β = − 0.077, p < 0.01; continuity and cooperation: β = − 0.136, p < 0.01; and organization of care: β = − 0.064, p < 0.01). Patient satisfaction was also associated with region, gender, insurance status, distance from the nearest medical/health-service institution, and number of visits to PCPs in the past year.ConclusionsPatients focused more on physicians’ benevolence than on their technical competence. Hence, medical humanities and communication skills education should be emphasized for PCPs. Regarding region-based and health-insurance-based differences, the inequities between eastern, central, and western provinces, as well as between urban and rural areas, must also be addressed.
Highlights
In rural areas of China, hypertension is on the rise and it is drawing the Chinese government’s attention
Long-term adherence to lifestyle improvement is the cornerstone of associated treatment approaches, and rational use of antihypertensive drugs is key to achieving normal blood pressure [6]
Trust is the foundation of the doctor-patient relationship, and given that patient satisfaction is an indicator of health service quality, high levels of trust and patient satisfaction indicate a good relationship between patients and service providers [9]
Summary
In rural areas of China, hypertension is on the rise and it is drawing the Chinese government’s attention. Studies have shown that primary-level institutions in the rural healthservice system – in which township health centers or community health-service centers represent primary hubs, and village clinics or community health-service stations represent the lowest level – have weak service capabilities and low resident satisfaction [10]. This is not conducive to effective long-term followup management of rural patients with hypertension and has a negative impact on the prevention and treatment of hypertension
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