Factors associated with outpatient experience of Chinese public hospitals: a cross-sectional study

Abstract

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...

Factors Associated with Outpatient Satisfaction in Tertiary Hospitals in China: A Systematic Review

“…After a full-text review of these 226 studies, 190 studies were excluded with the reasons ( Supplementary Material 3 ). A total of 36 articles reported 35 studies that met the inclusion criteria of this review [ 7 , 15 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. All studies were published in peer-reviewed journals.…”

“…All studies were published in peer-reviewed journals. Six of the studies were published in English [ 7 , 15 , 18 , 26 , 28 , 31 ], and 30 of the studies were published in Chinese. The selection process is summarized in Prisma searching flow diagram ( Figure 2 ).…”

<p>Outpatients’ Satisfaction in the Context of 10 Years of Health-Care Reform: A Cross-Sectional Study of Tertiary Hospitals in Shiyan, China</p>

“…Therefore, the problems of registration difficulty and slow payment have been alleviated. 17 It has been confirmed that patients' medical experiences have been improved to some extent by mobile health apps and other information technologies in medical institutions.…”

“…This finding indicated the problem that obtaining medical services became expensive. 17 In response to this situation, the local government also launched related policies, including provincial-level pooled tendering and procurement and a "zeromarkup" (ie, no-profit) policy for medicines on the new National Essential Drugs List at the grassroots level to lower the drug prices. 3 The basic medical insurance system was improved, government subsidies for basic medical insurance for urban and rural residents were raised to 520 RMB, and serious illness insurance increased by 15 RMB.…”

“…Recent studies have investigated the inpatient or outpatient satisfaction of primary medical institutions or public hospitals, such as the "National Healthcare Improvement Initiative" assessment survey implemented by the National Health Commission of the People's Republic of China. [11][12][13][14][15][16][17][18][19][20] Other studies on patient satisfaction focus on certain populations, such as cancer patients and surgical patients. 21,22 Patient satisfaction has been reported to be influenced by many subjective and objective factors, including patient demographic characteristics (age, race, gender, education, and health status), patient expectations, patient trust, patient social functioning, quality of medical service, medical staff, and administrative quality.…”