Perceived health-care quality in China: a comparison of second- and third-tier hospitals

Abstract

Objectives To evaluate disparity in service quality between second- and third-tier hospitals and explore factors that affect patients' perception of service quality in China. Design Cross sectional study. Setting Twelve hospitals in China. Participants 5714 patients. Intervention None. Main Outcome Measure Total score of the SERVQUAL scale and each of its five dimensions. Results Patients from third-tier hospitals rated significantly higher scores overall and in all the five dimensions of the SERVQUAL scale. Those with lower education, urban residents and those who had higher degree of life satisfaction and attention paid to health perceived higher service quality. Inpatients perceived higher service quality compared with outpatients. Conclusion We found a significant gap in patient's perceived service quality between second- and third-tier hospitals in China. A variety of demographic and personality factors were found to significantly influence patient's perceived service quality.

Association between health insurance cost-sharing and choice of hospital tier for cardiovascular diseases in China: a prospective cohort study

“…Urban residents, particularly urban employees, may have been more familiar with the concept of insurance or better informed about differences in reimbursement policies than rural residents, as HI schemes have been implemented earlier than those in rural areas. 25 , 26 , 27 , 28 The somewhat surprising finding in rural areas of higher tier 2 and 3 deductibles being associated with higher use of these hospital tiers for stroke and IHD should not be over interpreted in view of the reported inelastic relationships between deductibles and choice of hospital tier. Tier 1 hospitals, especially in rural areas, frequently lack appropriate equipment and facilities for diagnosis and treatment and their quality of care is perceived as low, 29 a perception likely exacerbated for more severe conditions such as stroke and IHD.…”

Determination of a cut-off COmprehensive Score for financial Toxicity (COST) for identifying cost-related treatment nonadherence and impaired health-related quality of life among Chinese patients with cancer

“…Next, one tertiary and one secondary hospital were randomly selected from each of the six chosen cities, yielding a total of 12 hospitals. In the Chinese mainland, hospitals are classified into three tiers, namely primary, secondary, and tertiary, based on their size and the level of services provided [ 24 ]. Primary hospitals are typically township or community hospitals with fewer than 100 beds; these hospitals provide preventive care, minimal health care, and rehabilitation services to a single community.…”

Patient perceptions of healthcare service quality in Romania: Public versus private hospitals – Implications for developed and developing healthcare systems

“…[7,8] This paper addresses these gaps by developing a robust, contextualised and validated measurement model for assessing data from both public and private health facilities in Romania (the second largest new member state among CEECs). Furthermore, unlike prior studies that have assessed the impact of individual service quality attributes on patients' perceptions of overall healthcare services, [9,10] this paper addresses the distinct paucity of research on patient service attribute perceptions associated with different types of healthcare services offered, e.g., primary care, ambulatory care, and inpatient care. Few studies examined healthcare service quality according to the type of service accessed by patients.…”

“…A modified SERVQUAL instrument designed originally by Parasuraman et al [15,16] was used to measure service attributes in the healthcare context similar to previous studies. [10,[17][18][19][20][21] This scale captures patient perceptions of a service along five dimensions, including tangibles which measure physical facilities whether the employees are neat in appearance, medical equipment is considered modern and if there are sufficient medical consumables such as gloves and needles; responsiveness (measures the provider's desire to assist customers and provide timely service); assurance (measures knowledge the provider and his/her ability to convey trust and confidence); and empathy (measures caring and personal attention). [16] Data for this research involved in-depth exploratory interviews and face-to-face interviews with 1,673 respondents in three private and public hospitals in Bucharest, the capital city of Romania with a population of over 1.75 million people.…”