Abstract
BackgroundEvaluations on different aspects of the performance of public hospitals in China have been conducted, usually based on indicators developed by literature review and expert suggestions. The patient perspective was not always considered. This study aims to identify what patients care most about in China’s public hospitals exclusively from a patient perspective.MethodsA mix of stratified sampling and typical sampling was used to select 15 public hospitals in Jiangsu Province of China. In each sampled hospital, a convenient sample of six outpatients and six inpatients was selected to conduct face-to-face individual interviews. An interview guide consisting of six open-ended questions was designed. Donabedian’s quality of care framework was applied to categorize themes and subthemes, which were generated from patients’ interviews by using the conventional content analysis approach. Frequencies of themes and subthemes were counted.ResultsNine key themes were identified regarding patients’ concerns about hospital care, which were environment and facilities, professional competence, hospital reputation, and morals of medical staff in the “structure” category of Donabedian’s framework, caring attitudes and emotional support, medical costs, communication and information, and efficiency and coordination of care in the “process” category, and health outcomes in the “outcome” category.ConclusionsThis study has identified and prioritized the aspects that patients care most about in China’s public hospitals in Jiangsu Province exclusively from a patient perspective. A measurement tool of patient-reported experiences in public hospitals could be built based on this study. Efforts should be made to represent the patient perspective to further improve the reform of public hospitals in China.
Highlights
Evaluations on different aspects of the performance of public hospitals in China have been conducted, usually based on indicators developed by literature review and expert suggestions
Setting The sampled public hospitals in this study were all located at Jiangsu Province, as Jiangsu is one of the four pilot provinces to implement a comprehensive healthcare reform, and Zhenjiang City in Jiangsu Provinces is one of the 17 first-batch pilot cities that implemented pilot public hospital reforms
There were 145 interviewees having information on age ranging from 21 to 91 years old, among which 37% were in the age group 21-44 years old, 35% fell into the 4564 years old group, and the remaining 28% were 65 years old or above
Summary
Evaluations on different aspects of the performance of public hospitals in China have been conducted, usually based on indicators developed by literature review and expert suggestions. This study aims to identify what patients care most about in China’s public hospitals exclusively from a patient perspective. As the backbone of health services in China, public hospitals provide 89% of hospital bed-days and 92% of outpatient visits [1, 2]. The majority of Chinese public hospitals are both regulated and operated by the government [5]. Government financing, charges on health services, and 15% mark-up on drugs were the main sources of revenues for Chinese public hospitals in the past [4]. In 2009, the Chinese Government launched a nationwide health-care reform, and identified the public hospital reform as one core target [6]. The desired results of China’s health-care reform cannot be fully achieved unless the efficiency in public hospitals has been improved and the growth of health expenditure has been under control [3, 7]
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