Xiong Change, Chen Xiao, Zhao Xinyuan, Liu Chaojie
Change Xiong, Department of Social Medicine and Health Management, School of Basic Medical Science, Hubei University of Science and Technology, 88 Xianning Road, Xianning, 437100, People's Republic of China.
Xiao Chen, Institute of Medicine, Hubei University of Science and Technology, 88 Xianning Road, Xianning, 437100, People's Republic of China.
BMC Health Serv Res. 2018 Mar 27;18(1):217. doi: 10.1186/s12913-018-3011-3.
Patient satisfaction is associated with both individual (patients and health workers) and organizational (health facilities) characteristics. This study aimed to establish a link between patient satisfaction and gender composition of physicians in community health service (CHS) organizations.
Participants were selected through multistage stratified random sampling: 36 CHS centers were selected from six municipalities in Hubei, China. All physicians on duty and patients visiting the CHS during the study period (from April to October in 2015) were invited to participate in this study: 324 physicians and 865 patients completed a questionnaire survey. Multilevel linear regression analyses were performed to determine the associations of patient satisfaction (scored from 1 to 5) with patient characteristics (gender, age, education, income, medical expense, frequency of visits to the CHS) and organizational features of the CHS (sex ratio of physicians, and gender differences of physicians in education and job satisfaction).
Older patients and those with a higher medical bill had a lower degree of satisfaction (p < 0.05). At the organizational level: a higher proportion of male physicians weakened the negative association between patient age and patient satisfaction (p < 0.05); a larger gap in university qualifications between male and female physicians exacerbated the negative association between patient age and patient satisfaction (p < 0.05).
The gender composition of physicians in CHSs is associated with patient satisfaction in the Chinese context: a larger gap (in number and qualifications) between male and female physicians is associated with higher patient satisfaction. Further studies are needed to explore the cultural roots of such an association.
患者满意度与个体特征（患者和医护人员）及组织特征（医疗机构）均相关。本研究旨在建立社区卫生服务（CHS）机构中患者满意度与医生性别构成之间的联系。
通过多阶段分层随机抽样选取参与者：从中国湖北省的六个城市中选取了36个社区卫生服务中心。邀请了研究期间（2015年4月至10月）所有值班医生以及前往社区卫生服务中心就诊的患者参与本研究：324名医生和865名患者完成了问卷调查。进行多水平线性回归分析，以确定患者满意度（评分从1至5）与患者特征（性别、年龄、教育程度、收入、医疗费用、前往社区卫生服务中心就诊的频率）以及社区卫生服务机构的组织特征（医生性别比，以及医生在教育程度和工作满意度方面的性别差异）之间的关联。
年龄较大的患者和医疗费用较高的患者满意度较低（p < 0.05）。在组织层面：男性医生比例较高减弱了患者年龄与患者满意度之间的负相关（p < 0.05）；男女医生在大学学历方面的差距越大，加剧了患者年龄与患者满意度之间的负相关（p < 0.05）。
在中国背景下，社区卫生服务机构中医生的性别构成与患者满意度相关：男女医生之间（在数量和资质方面）差距越大，患者满意度越高。需要进一步研究来探索这种关联的文化根源。
