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. 2019 Feb 6;18(1):29.
doi: 10.1186/s12939-019-0932-3.

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

Xuanxuan Wang  1   2 , Jiaying Chen  3   4 , Bo Burström  5   6 , Kristina Burström  2   5   6
Affiliations

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

Xuanxuan Wang et al. Int J Equity Health. .

Abstract

Background: 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.

Methods: Data 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.

Results: Compared 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.

Conclusions: Levels 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.

Keywords: China; Patient satisfaction; Patient-reported experiences; Public hospitals; Structural equation modeling.

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Conflict of interest statement

Ethics approval and consent to participate

As only individual interviews were conducted in this study, it was unnecessary to seek ethics approval for this study according to The Ethical Review Policy of Human Biomedical Research issued by China’s former Ministry of Health [32]. Although no official ethics approval was sought for this study, the research group did follow standard procedures to obtain oral informed consent from each participant.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
The conceptual model adapted from Donabedian’s model
Fig. 2
Fig. 2
Path coefficients of direct effects in the path model outpatients’ general satisfaction and experiences of care at of city-level public hospitals
Fig. 3
Fig. 3
Path coefficients of direct effects in the path model of outpatients’ general satisfaction and experiences of care at county-level public hospitals
See this image and copyright information in PMC

References

    1. Stepurko T, Pavlova M, Groot W. Overall satisfaction of health care users with the quality of and access to health care services: a cross-sectional study in six central and eastern European countries. BMC Health Serv Res. 2016;16:342. doi: 10.1186/s12913-016-1585-1. - DOI - PMC - PubMed
    1. Trzeciak S, Gaughan JP, Bosire J, Mazzarelli AJ. Association between Medicare summary star ratings for patient experience and clinical outcomes in US hospitals. J Patient Exp. 2016;3:6–9. doi: 10.1177/2374373516636681. - DOI - PMC - PubMed
    1. Gupta D, Lis CG, Rodeghier M. Can patient experience with service quality predict survival in colorectal cancer? J Healthc Qual. 2013;35:37–43. doi: 10.1111/j.1945-1474.2012.00217.x. - DOI - PubMed
    1. Rademakers J, Delnoij D, de Boer D. Structure, process or outcome: which contributes most to patients' overall assessment of healthcare quality? BMJ Qual Saf. 2011;20:326–331. doi: 10.1136/bmjqs.2010.042358. - DOI - PubMed
    1. Hekkert KD, Cihangir S, Kleefstra SM, van den Berg B, Kool RB. Patient satisfaction revisited: a multilevel approach. Soc Sci Med. 2009;69:68–75. doi: 10.1016/j.socscimed.2009.04.016. - DOI - PubMed

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