Hangzhou Normal University, Hangzhou, China.
Hangzhou Medical College, Hangzhou, China.
Inquiry. 2021 Jan-Dec;58:46958021999926. doi: 10.1177/0046958021999926.
This cross-sectional study aims to assess the Chinese population's satisfaction with health service and identify 2 types of variables, Andersen's behavioral model related variables and social environment variables associated with high satisfaction. Data were derived from the 2013 Chinese General Social Survey (CGSS). Using exploratory factor analysis, the original questionnaire's 10 health services were grouped into 2 dimensions, including "health management service" and "public health service." Then, the satisfaction was described. The associations between satisfaction and factors were assessed using a multivariable logistic regression model. As a result, a total of 5283 subjects were enrolled. The satisfaction was 56.74% for "health management service" and 54.48% for "public health service." Those with older age, lower education level, positive social environment factors (ie, higher perceived social class, higher perceived social trust, and perceived social equity), and having pension were more likely to report high satisfaction. Moreover, compared to the east region (the most prosperous region), the individuals from the central region or the north-east region (both regional economic levels were medium) had lower odds of reporting high satisfaction. In comparison, those from the west region (the least developed region) had higher odds. In conclusion, actionable measures to increase satisfaction should be proposed by the Chinese government, including increasing pension insurance coverage, increasing investment in health services, creating an excellent social environment, etc.
本横断面研究旨在评估中国民众对卫生服务的满意度,并确定与高满意度相关的两类变量,即 Andersen 行为模型相关变量和社会环境变量。数据来自 2013 年中国综合社会调查(CGSS)。采用探索性因子分析,将原始问卷的 10 项卫生服务分为“健康管理服务”和“公共卫生服务”两个维度进行描述。然后,采用多变量逻辑回归模型评估满意度与各因素之间的关联。结果共纳入 5283 名受试者。“健康管理服务”的满意度为 56.74%,“公共卫生服务”的满意度为 54.48%。年龄较大、受教育程度较低、社会环境因素积极(即感知社会阶层较高、感知社会信任度较高、感知社会公平度较高)和有养老金的人群更有可能报告高满意度。此外,与东部地区(最繁荣地区)相比,来自中部地区或东北地区(经济水平均为中等)的人群报告高满意度的可能性较低,而来自西部地区(最不发达地区)的人群报告高满意度的可能性较高。总之,中国政府应提出切实可行的措施来提高满意度,包括扩大养老保险覆盖范围、增加卫生服务投资、营造良好的社会环境等。