Department of Economics, School of Economics and Management, Tsinghua University, Beijing 100084, China.
Health Qual Life Outcomes. 2013 Feb 13;11:18. doi: 10.1186/1477-7525-11-18.
Although the Chinese government put a lot of effort into promoting the community patient's life satisfaction, there still lacked the holistic and systematic approaches to promote the community patient's life satisfaction in various regions of China. On the basis of the literature, it was found that both the community patient's assessment of community medical service and trust in community health delivery system were important considerations when the community patient comprehensively evaluated community medical service to generate life satisfaction. So this study was set up to test whether and to what extent the community patient's assessments of various major aspects of community medical service/various major aspects of the community patient's trust in community health delivery system influenced life satisfaction in whole China/in various regions of China.
In order to explore the situation of China's community health delivery system before 2009 and provide a reference for China's community health delivery system reform, the data that could comprehensively and accurately reflect the community patient's life satisfaction, assessment of community medical service, and trust in community health delivery system in various regions of China was needed, so this study collaborated with the National Bureau of Statistics of China to carry out a large-scale 2008 national community resident household survey (N = 3,306) for the first time in China. And the specified ordered probit models were established to analyze the dataset from this household survey.
Among major aspects of community medical service, the medical cost (particularly in developed regions), the doctor-patient communication (particularly in developed regions), the medical facility and hospital environment (particularly in developed regions), and the medical treatment process (particularly in underdeveloped regions) were all key considerations (p<0.05 for t statistics) in generating the community patient's life satisfaction. Among major aspects of the community patient's trust in community health delivery system, trust in doctor (particularly in underdeveloped regions), trust in prescription (particularly in underdeveloped regions), and trust in recommended medical examination (particularly in underdeveloped regions) were all important considerations (p<0.10 for t statistics) in generating the community patient's life satisfaction.
The reduction of medical cost (particularly in developed regions), the improvement of doctor-patient communication (particularly in developed regions), the promotion of medical facility and hospital environment (particularly in developed regions), the improvement of medical treatment process (particularly in underdeveloped regions), the promotion of trust in doctor (particularly in underdeveloped regions), the promotion of trust in prescription (particularly in underdeveloped regions), and the promotion of trust in recommended medical examination (particularly in underdeveloped regions) could help promote the community patient's life satisfaction.
尽管中国政府在提高社区患者生活满意度方面付出了很多努力,但中国各地区仍缺乏全面系统的方法来提高社区患者的生活满意度。在文献的基础上,发现社区患者对社区医疗服务的评估和对社区卫生服务提供系统的信任,是社区患者全面评估社区医疗服务以产生生活满意度的重要考虑因素。因此,本研究旨在检验社区患者对社区医疗服务的各个主要方面的评估/社区患者对社区卫生服务提供系统的各个主要方面的信任,是否以及在多大程度上影响了全国/中国各地区的生活满意度。
为了探索 2009 年之前中国社区卫生服务提供系统的情况,为中国社区卫生服务提供系统改革提供参考,本研究需要获得能够全面准确反映中国各地区社区患者生活满意度、社区医疗服务评估和社区卫生服务提供系统信任的综合数据,因此,本研究首次与中国国家统计局合作,在中国进行了一次大规模的 2008 年全国社区居民家庭调查(N=3306)。并建立了特定的有序概率模型来分析该家庭调查数据集。
在社区医疗服务的主要方面,医疗费用(特别是在发达地区)、医患沟通(特别是在发达地区)、医疗设施和医院环境(特别是在发达地区)以及医疗治疗过程(特别是在欠发达地区)都是产生社区患者生活满意度的关键考虑因素(t 统计量 p<0.05)。在社区患者对社区卫生服务提供系统的主要方面的信任中,对医生的信任(特别是在欠发达地区)、对处方的信任(特别是在欠发达地区)以及对推荐的体检的信任(特别是在欠发达地区)都是产生社区患者生活满意度的重要考虑因素(t 统计量 p<0.10)。
降低医疗费用(特别是在发达地区)、改善医患沟通(特别是在发达地区)、促进医疗设施和医院环境(特别是在发达地区)、改善医疗治疗过程(特别是在欠发达地区)、提高对医生的信任(特别是在欠发达地区)、提高对处方的信任(特别是在欠发达地区)、提高对推荐体检的信任(特别是在欠发达地区)有助于提高社区患者的生活满意度。