Exploring pathways to outpatients\u2019 satisfaction with health care in Chinese public hospitals in urban and rural areas using patient-reported experiences

Xuanxuan Wang,Jiaying Chen,Bo Burström,Kristina Burström

doi:10.1186/s12939-019-0932-3

Xuanxuan Wang, Jiaying Chen + Show 2 more

Open Access

https://doi.org/10.1186/s12939-019-0932-3

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Abstract

BackgroundThis study aimed to measure outpatients’ general satisfaction with and experiences of different aspects of health care in Chinese public hospitals and to investigate to what extent general satisfaction could be explained by patients’ experiences in public hospitals located at urban and rural areas.MethodsData on 4782 outpatients were derived from a patient survey in 9 city-level (urban) and 16 county-level (rural) public hospitals across China in 2016. According to Donabedian’s model, questions on patients’ experiences were categorized into six aspects under “structure” and “process”, with general satisfaction representing “outcome”. The Chi-square tests were used to test the differences in patients’ experiences and general satisfaction between urban and rural areas. The Partial Least Squares Structural Equation Modeling (PLS-SEM) was used to estimate effects of patients’ experiences on general satisfaction.ResultsCompared with respondents in rural areas, there were significantly higher percentages of respondents in urban areas reporting satisfaction and positive experiences in most aspects. As manifested by the path coefficients in PLS models, the positive effect of professional competence (0.197) on general satisfaction was the most significant in respondents at urban areas, followed by communication and information (0.183), and caring attitudes and emotional support (0.174). Among respondents at rural areas, the positive effect of environment facilities (0.199) was the most significant, followed by caring attitudes and emotional support (0.188), and professional competence (0.179). The PLS models explained 44.9 and 46.0% of variations in patient satisfaction at urban and rural areas, respectively.ConclusionsLevels of patient satisfaction and experiences at Chinese public hospitals were higher in urban than in rural areas. Outpatients’ experiences of professional competence, caring attitudes and emotional support were strongly related to their satisfaction in both settings. However, among respondents in urban areas, experiences of communication and information were more strongly related to satisfaction, whereas among respondents in rural areas, experiences of environment and facilities were more strongly related to satisfaction.

Highlights

This study aimed to measure outpatients’ general satisfaction with and experiences of different aspects of health care in Chinese public hospitals and to investigate to what extent general satisfaction could be explained by patients’ experiences in public hospitals located at urban and rural areas
Conceptual framework This study aimed to: 1) measure outpatients’ general satisfaction with and experiences of different aspects of health care provided in Chinese public hospitals; and 2) investigate to what extent general satisfaction with care is explained by patients’ experiences of specific aspects of care in public hospitals in China’s urban and rural areas
The research group consulted with officials from the System Reform Division of National Health and Family Planning Commission (NHFPC) on which cities and counties that had implemented tangible reform policies in their public hospitals

Summary

Introduction

This study aimed to measure outpatients’ general satisfaction with and experiences of different aspects of health care in Chinese public hospitals and to investigate to what extent general satisfaction could be explained by patients’ experiences in public hospitals located at urban and rural areas. Patient satisfaction with health care is an important and commonly used indicator of quality [1]. Patient-Reported Experience Measures (PREMs) can capture the underlying components, i.e. patients’ perception of their personal experiences of various aspects of the health care they have received [7], which can help identify tangible priorities and offer actionable indicators for quality improvement [8, 9]. Measuring and relating the general satisfaction to patients’ experiences can lead to an in-depth understanding of patient satisfaction and highlight the opportunities to improve health care [10]

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