Patient experience of hospital care in China: major findings from the Chinese Patient Experience Questionnaire Survey (2016-2018)

Abstract

Objectives: China launched the National Healthcare Improvement Initiative (NHII) in 2015 to improve patient experiences in healthcare. This study aimed to generate evidence of hospital care quality from the patients' perspective.

Design: This nationwide cross-sectional study interviewed participants from 31 provinces, municipalities and autonomous regions across China.

Setting: A total of 117 tertiary hospitals in mainland China.

Participants: 48 422 responses from outpatients and 35 957 responses from inpatients were included in this study.

Primary outcome measure: The scores of six predefined domains in the Chinese Patient Experience Questionnaire, five of which were designed to reflect specific dimensions of care, and one of which indicated the overall rating.

Results: More than 80% of the respondents viewed their care experiences as positive. The NHII seems to have had a positive impact, as indicated by the steady, although unremarkable, increase in the patient experience scores over the 2016-2018 period. The Chinese patients generally reported a positive experience with the clinical aspects of care, but reported a less positive experience with the environmental, interpersonal and social services aspects of care. The institutional factors, including region and type of hospital, and personal factors, such as gender, age, education and occupation, were factors affecting the patient experience in China. Humanistic care was the aspect of care with the greatest association with the overall patient experience rating in both the outpatient and inpatient settings.

Conclusions: The national survey indicated an overall positive patient perspective of care in China. Older age, higher education level and formal employment status were found to be correlated with positive care experiences, as were higher levels of economic development of the region, a more generous insurance benefits package and a higher degree of coordinated care. The interpersonal-related initiatives had substantial roles in the improvement of the patient experience. In the regions where farmers and users of traditional Chinese medicine services constitute a greater proportion of the population, improvement of patient experiences for these groups deserves special policy attention.

Keywords: health policy; patient experience; quality in healthcare.

Figure 1

Flowchart of study participant selection in the CPEQ survey. CPEQ, Chinese Patient Experience Questionnaire; TCM, traditional Chinese medicine hospital; OB/Gyn,obstetrics and gynaecology hospital.

Figure 2

Percentage of patients who reported a positive care experience on specific CPEQ components in 2016 and 2018. CPEQ, Chinese Patient Experience Questionnaire.

Figure 3

Performance scores for the 23 individual items of the CPEQ-A, by hospital category, for both survey years combined. The numbers indicate the specific score across items in the CPEQ-A for each hospital category by using the pooled data of the two survey rounds, with the greenest colour indicating the best performance and reddest colour indicating the worst. CPEQ-A, Chinese Patient Experience Questionnaire for Ambulatory care; TCM, traditional Chinese medicine hospital; OB/Gyn, obstetrics and gynaecology hospital.

Figure 4

Performance scores for the 19 individual items of the CPEQ-I, by hospital category, for both survey years combined. The numbers indicate the specific score across items in the CPEQ-I for each hospital category by using the pooled data of the two survey rounds, with the greenest colour indicating the best performance and reddest colour indicating the worst. CPEQ-I, Chinese Patient Experience Questionnaire for Inpatient care; TCM, traditional Chinese medicine hospital; OB/Gyn, obstetrics and gynaecology hospital.