Zhai Shaoguo, Wang Pei, Wang Anli, Dong Quanfang, Cai Jiaoli, Coyte Peter C
School of Public Administration, Northwest University, 1 Xuefu Road, Chang'an District, Xi'an, Shaanxi, 710127, China.
School of Politics and Administration, Xianyang Normal University, Wenlin Road, Xianyang, Shaanxi, 712000, China.
Global Health. 2017 Aug 28;13(1):67. doi: 10.1186/s12992-017-0292-y.
With implementation of Chinese universal healthcare, the performance of urban and rural residents' healthcare and the degree of satisfaction with publicly financed health services have become a hot issue in assessing health reforms in China. An evaluation model of health services in community and evaluation indexes of health-system performance have been put forward in related researches. This study examines variation in satisfaction with publicly financed health services among urban and rural residents in five Chinese cities and assesses their determinants.
The data are derived from a survey of 1198 urban and rural residents from five nationally representative regions concerning their perceptions of satisfaction with China's publicly financed health services. The respondents assessed their degree of satisfaction with publicly financed health services on a 5-point Likert scale. It is a kind of questionaire scale that features the answers for 1-5 points labeled very unsatisfied, unsatisfied, neither unsatisfied nor satisfied, satisfied and very satisfied linking to each factor or variable, where a score of 1 reflects the lowest degree of satisfaction and a score of 5 represents the highest degree. The logistic regression methods are used to identify the variables into its determining components.
The overall satisfaction degree representing satisfaction of all factors (variables) is 3.02, which is at the middle level of a 1-5 Likert scale, inferring respondents' neutral attitude to publicly financed health services. According to the correlation test, the factors with characteristic root greater than 0.5 are chosen to take the factor analysis and 12 extracted factors can explain 77.97% of original 18 variables' total variance. Regression analysis based on the survey data finds that health records, vaccinations, pediatric care, elder care, and mental health management are the main factors accounting for degree of satisfaction with publicly financed health services for both urban and rural residents.
What can be done to increase the degree of satisfaction with health services needs to be considered based on our findings. Regression analysis based on the survey data finds that health records, vaccinations, pediatric care, elder care, and mental health management are the main factors accounting for degree of satisfaction with publicly financed health services for both urban and rural residents. Therefore, with improvements in health records, timely vaccination, elder care for women or elder, pediatric care and major psychosis management, degree of satisfaction with publicly financed health services are likely to grow.
随着中国全民医保的实施，城乡居民的医疗保健表现以及对公共财政资助的医疗服务的满意度，已成为评估中国医疗改革的热点问题。相关研究中已提出社区卫生服务评价模型和卫生系统绩效评价指标。本研究考察了中国五个城市城乡居民对公共财政资助的医疗服务满意度的差异，并评估了其决定因素。
数据来源于对来自五个具有全国代表性地区的1198名城乡居民进行的关于他们对中国公共财政资助的医疗服务满意度看法的调查。受访者采用5级李克特量表对他们对公共财政资助的医疗服务的满意度进行评估。这是一种问卷量表，其特点是1 - 5分的答案分别标记为非常不满意、不满意、既不满意也不不满意、满意和非常满意，与每个因素或变量相对应，其中1分表示最低满意度，5分表示最高满意度。采用逻辑回归方法将变量分解为其决定因素。
代表所有因素（变量）满意度的总体满意度为3.02，处于1 - 5李克特量表的中等水平，表明受访者对公共财政资助的医疗服务持中立态度。根据相关性检验，选择特征根大于0.5的因素进行因子分析，提取的12个因素可解释原始18个变量总方差的77.97%。基于调查数据的回归分析发现，健康记录、疫苗接种、儿童保健、老年护理和心理健康管理是影响城乡居民对公共财政资助的医疗服务满意度的主要因素。
根据我们的研究结果，需要考虑如何提高医疗服务满意度。基于调查数据的回归分析发现，健康记录、疫苗接种、儿童保健、老年护理和心理健康管理是影响城乡居民对公共财政资助的医疗服务满意度的主要因素。因此，随着健康记录的改善、及时接种疫苗、为妇女或老年人提供老年护理、儿童保健和严重精神疾病管理的改进，对公共财政资助的医疗服务的满意度可能会提高。
