School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, 200030, P.R. China.
Institute of Hospital Management, Tsinghua University, Shenzhen, P.R. China.
Int J Qual Health Care. 2021 Feb 3;33(1). doi: 10.1093/intqhc/mzab003.
The aims of this study were to investigate and compare patient satisfaction with outpatient care in public secondary and tertiary hospitals in China and to explore the factors affecting patient satisfaction for improving the quality of outpatient care in public hospitals.
This cross-sectional study comprised a sample survey of 11 097 adults in 31 provincial cities in China from February to April 2018. A pretested structured questionnaire was used to collect outpatient experience data through a computer-assisted telephone interviewing system. Patient satisfaction was assessed using nine questions answered on a 4-point Likert scale. Multivariate regression models were employed to examine the relationships of patient satisfaction with outpatient services and healthcare provider level and to identify the factors associated with satisfaction.
Patient's overall satisfaction score with outpatient care was 27.3 (SD = 3.8), with lower scores observed in tertiary hospitals than in secondary hospitals (27.3 vs. 27.6, P < 0.05). The domain with the highest satisfaction was 'consulting environment', and the domain with the lowest satisfaction was 'patient waiting time in the hospital'. Patients who went to tertiary hospitals reported lower satisfaction in 'patient waiting time in the hospital', 'medical expenses', 'patient length of treatment time' and 'attitudes of other health workers' than patients who went to secondary hospitals (P < 0.05). In secondary hospitals, no significant difference in patient satisfaction was observed between different sociodemographic categories (P > 0.05). In tertiary hospitals, female and single respondents were more likely to have higher satisfaction (P < 0.05), whereas respondents with high school or junior college degrees were more likely to have lower satisfaction (P < 0.05).
The aforementioned results suggested that tertiary hospitals face larger challenges in patient satisfaction with outpatient care than secondary hospitals. Measures must be adopted to improve patient satisfaction with outpatient care in future healthcare reforms. Patient waiting time, medical expenses and treatment duration especially require improvements in tertiary hospitals.
本研究旨在调查和比较中国公立二级和三级医院门诊患者的满意度，并探讨影响患者满意度的因素，以提高公立医院门诊服务质量。
本横断面研究采用样本调查，于 2018 年 2 月至 4 月在中国 31 个省级城市抽取了 11097 名成年人。通过计算机辅助电话访谈系统使用经过预测试的结构化问卷收集门诊体验数据。采用 4 级 Likert 量表回答 9 个问题评估患者对门诊服务的满意度。采用多变量回归模型分析患者对门诊服务的满意度与医疗服务提供者水平的关系，并确定与满意度相关的因素。
患者对门诊服务的总体满意度评分为 27.3（SD=3.8），三级医院的得分低于二级医院（27.3 分比 27.6 分，P＜0.05）。满意度最高的领域是“咨询环境”，满意度最低的领域是“医院内患者等候时间”。与去二级医院的患者相比，去三级医院的患者在“医院内患者等候时间”“医疗费用”“患者治疗时间”和“其他卫生工作者态度”方面的满意度较低（P＜0.05）。在二级医院，不同社会人口学特征类别的患者满意度无显著差异（P＞0.05）。在三级医院，女性和单身受访者更有可能有较高的满意度（P＜0.05），而具有高中或大专学历的受访者更有可能有较低的满意度（P＜0.05）。
上述结果表明，与二级医院相比，三级医院在门诊患者满意度方面面临更大的挑战。在未来的医疗改革中，必须采取措施提高患者对门诊服务的满意度。患者等待时间、医疗费用和治疗持续时间尤其需要在三级医院得到改善。
