BackgroundThe proliferation of mobile health apps has greatly changed the way society accesses the health care industry. However, despite the widespread use of mobile health apps by patients in China, there has been little research that evaluates the effect of mobile health apps on patient experience during hospital visits.ObjectiveThe purpose of our study was to examine whether the use of mobile health apps improves patient experience and to find out the difference in patient experience between users and nonusers and the characteristics associated with the users of these apps.MethodsWe used the Chinese Outpatient Experience Questionnaire to survey patient experience. A sample of 300 outpatients was randomly selected from 3 comprehensive public hospitals (3 tertiary hospitals) in Hubei province, China. Each hospital randomly selected 50 respondents from mobile health app users and 50 from nonusers. A chi-square test was employed to compare the different categorical characteristics between mobile health app users and nonusers. A t test was used to test the significance in continuous variables between user scores and nonuser scores. Multiple linear regression was conducted to determine whether the use of mobile health apps during hospital visits was associated with patient experience.ResultsThe users and nonusers differed in age (χ22=12.2, P=.002), education (χ23=9.3, P=.03), living place (χ21=7.7, P=.006), and the need for specialists (χ24=11.0, P=.03). Compared with nonusers, mobile health app users in China were younger, better educated, living in urban areas, and had higher demands for specialists. In addition, mobile health app users gave significantly higher scores than nonusers in total patient experience scores (t298=3.919, P<.001), the 18 items and the 5 dimensions of physician-patient communication (t298=2.93, P=.004), health information (t298=3.556, P<.001), medical service fees (t298=3.991, P<.001), short-term outcome (t298=4.533, P<.001), and general satisfaction (t298=4.304, P<.001). Multiple linear regression results showed that the use of mobile health apps during hospital visits influenced patient experience (t289=3.143, P=.002). After controlling for other factors, it was shown that the use of mobile health apps increased the outpatient experience scores by 17.7%. Additional results from the study found that the self-rated health status (t289=3.746, P<.001) and monthly income of patients (t289=2.416, P=.02) influenced the patient experience as well.ConclusionsThe use of mobile health apps could improve patient experience, especially with regard to accessing health information, making physician-patient communication more convenient, ensuring transparency in medical charge, and ameliorating short-term outcomes. All of these may contribute to positive health outcomes. Therefore, we should encourage the adoption of mobile health apps in health care settings so as to improve patient experience.

ObjectiveThe purpose of our study is to develop a mental workload scale for physicians in China and assess the scale’s reliability and validity.DesignThe instrument was developed over three phases involving 396 physicians from different tiers of comprehensive public hospitals in China. In the first phase, an initial item pool was developed through a systematic literature review. The second phase consisted of two rounds of Delphi expert consultations and a pilot survey. The third phase tested the reliability and validity of the instrument.SettingPublic hospitals in China.ParticipantsA total of 396 physicians from different tiers of comprehensive public hospitals in China participated in this study in 2018.Primary and secondary outcome measuresCronbach’s α, content validity index, item-total score correlation coefficient, dimension-total score correlation coefficient and indices of confirmatory factor analysis.ResultsSix dimensions (mental demands, physical demands, temporal demands, perceived risk, frustration level and performance) and 12 items were identified in the instrument. For reliability, Cronbach’s α for the whole scale was 0.81. For validity, the corrected item-content validity index of each item ranged from 0.85 to 1, item-total score correlation coefficients ranged from 0.31 to 0.75, and the correlation coefficients between the dimensions and total score ranged from 0.37 to 0.72. The results of the confirmatory factor analysis showed that the goodness-of-fit indices of the scale were satisfactory.ConclusionThe instrument showed good reliability and validity, and it is useful for diagnosing the mental workload of physicians.

The OPEQ is a promising instrument covering the most important aspects which influence outpatient experiences of comprehensive public hospital in China. It has good evidence for acceptability, validity and reliability.

Hospitals are struggling to involve patients and learn from their experience. The risk factor of patient experience is increasingly recognized as a critical component in improving patient experience. Our study explored risk factors of negative patient experience in order to improve the health-service quality of public hospitals. We conducted a cross-sectional study in Hubei province, China. A total of 583 respondents were surveyed by the Outpatient Experience Questionnaire with good validity and reliability in July 2015. T -tests were conducted to compare the experience scores among different outpatient groups. Multiple linear regression was performed to determine the significant factors that influenced the outpatient experience. Outpatients between 18 and 44 years old had the lowest experience scores (65.89 ± 0.79), whereas outpatients completely paying out-of-pocket had the lowest experience scores (64.68 ± 0.81) among all participants. Outpatients with poor self-rated health status had the lowest experience scores (66.14 ± 1.61) among different self-rated health status groups. While age, type of payment, and self-rated health status were significantly risk factors that influenced outpatient experience in the multiple linear regression. Thus, health-care providers should pay more attention to outpatients who are young (age <45), completely out-of-pocket and poor health status, and provide precision health care to improve outpatient experience.

Background Patient experience is an important indicator of health-care quality from the patient's view and has a better evidence-based characteristic than patient satisfaction. In this study, we compared the experience among different outpatient groups and explored the influencing factors of the outpatient experience to improve outpatient experience and the health-service quality of public hospitals in China.Methods Six comprehensive public hospitals in Hubei, China, were chosen by typical sampling method and including three tertiary hospitals and three secondary hospitals. In each hospital, 100 outpatients were invited to participate in the survey when they ended their visits. The questionnaire had good reliability and validity (the Cronbach's α coefficient of the overall questionnaire was 0·948). The inclusion criteria of participants were: (1) aged ≥18 years;(2) visit procedure were completed; and (3) ability to describe their experience accurately. A five-point Likert scale was used in the questionnaire. Outpatient experience score was calculated by transforming the five-point into hundredmarked system (score 5=100 points; score 4=75 points; score 3=50 points; scorer 2=25 points; score 1=0 points. 100 points means best experience, 0 points means worst experience. The cross-sectional survey was done by data collection. One-way Anova and independent t-test were used to assess the difference between demographic variables in outpatient experience. Multiple linear regression was used to assess how those demographic variables affected the experience. This study was approved by the Ethics Committee of Tongji Medical College, Huazhong University of Science and Technology (IORG number IORG0003571). FindingsOf the 600 participants who were eligible for inclusion, 17 were excluded because of missing data in the questionnaires and logical errors, and 583 eligible questionnaires were included for further analysis. 176 respondents had a poor experience (score<50) when they visited hospitals. The mean score of medical cost experience was the lowest (61·16 [SD 0·86]), whereas health information got the highest experience score (71·37 [0·79]). Age (β=0·213, p<0·0001), type of payment (β=0·159, p<0·0001), and the self-rated health status (β=0·261, p<0·0001) were associated with outpatient experience. Outpatients older than 65 years had the highest experience score (74·25 [1·88]), whereas outpatients paying out-of-pocket had the lowest experience score (64·68 [0·81]) among all participants. Outpatients with good self-rated health status had the highest experience score (72·63 [0·99]) among different self-rated health status groups. No association was found between sex, education, average income, residence, and marital status and experience score (p<0·0001).Interpretation Young outpatients (younger than 45 years) who paid entirely out-of-pocket and who had poor self-rated health status should be particularly focused on to improve the outpatient experience. Outpatients with poor self-rated health status are more prone to discomfo...