Institute of Medical Information/Center for Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMJ Open. 2019 Sep 20;9(9):e031615. doi: 10.1136/bmjopen-2019-031615.
China launched the National Healthcare Improvement Initiative (NHII) in 2015 to improve patient experiences in healthcare. This study aimed to generate evidence of hospital care quality from the patients' perspective.
This nationwide cross-sectional study interviewed participants from 31 provinces, municipalities and autonomous regions across China.
A total of 117 tertiary hospitals in mainland China.
48 422 responses from outpatients and 35 957 responses from inpatients were included in this study.
The scores of six predefined domains in the Chinese Patient Experience Questionnaire, five of which were designed to reflect specific dimensions of care, and one of which indicated the overall rating.
More than 80% of the respondents viewed their care experiences as positive. The NHII seems to have had a positive impact, as indicated by the steady, although unremarkable, increase in the patient experience scores over the 2016-2018 period. The Chinese patients generally reported a positive experience with the clinical aspects of care, but reported a less positive experience with the environmental, interpersonal and social services aspects of care. The institutional factors, including region and type of hospital, and personal factors, such as gender, age, education and occupation, were factors affecting the patient experience in China. Humanistic care was the aspect of care with the greatest association with the overall patient experience rating in both the outpatient and inpatient settings.
The national survey indicated an overall positive patient perspective of care in China. Older age, higher education level and formal employment status were found to be correlated with positive care experiences, as were higher levels of economic development of the region, a more generous insurance benefits package and a higher degree of coordinated care. The interpersonal-related initiatives had substantial roles in the improvement of the patient experience. In the regions where farmers and users of traditional Chinese medicine services constitute a greater proportion of the population, improvement of patient experiences for these groups deserves special policy attention.
中国于 2015 年启动了国家医疗保健改善计划（NHII），以改善患者的医疗体验。本研究旨在从患者的角度生成医院护理质量的证据。
这是一项全国性的横断面研究，对来自中国 31 个省、市和自治区的参与者进行了访谈。
中国大陆共有 117 家三级医院。
本研究共纳入 48422 名门诊患者和 35957 名住院患者的回复。
中国患者体验问卷中六个预先确定领域的评分，其中五个旨在反映护理的特定维度，一个反映总体评分。
超过 80%的受访者认为他们的护理体验是积极的。NHII 似乎产生了积极的影响，因为患者体验评分在 2016-2018 年期间呈稳步上升趋势，虽然不显著。中国患者普遍对护理的临床方面有积极的体验，但对环境、人际关系和社会服务方面的体验则不太积极。机构因素，包括地区和医院类型，以及个人因素，如性别、年龄、教育程度和职业，是影响中国患者体验的因素。人文关怀是门诊和住院患者整体体验评分中与患者体验相关性最大的护理方面。
全国性调查表明，中国患者对护理的总体看法是积极的。研究发现，年龄较大、受教育程度较高和正规就业与积极的护理体验相关，地区经济发展水平较高、保险福利计划较慷慨以及协调护理程度较高也与积极的护理体验相关。人际关系相关举措在改善患者体验方面发挥了重要作用。在农民和中医药服务使用者占比较大的地区，应特别关注这些群体的患者体验改善。
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