School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an 710049, China.
School of Public Administration, Inner Mongolia University, Hohhot 010021, China.
Int J Environ Res Public Health. 2021 Apr 8;18(8):3931. doi: 10.3390/ijerph18083931.
As violent clashes between doctors and patients in China intensify, patient dissatisfaction has been identified as a major concern in the current healthcare reform in China. This study aims to investigate the main determinants of dissatisfaction with local medical services attributable to middle-aged and elderly characteristics and identify areas for improvement. A total of 14,263 rural participants and 4898 urban participants were drawn from the China Health and Retirement Longitudinal Study in 2018. Dissatisfaction was measured by two methods: binary outcome (1 = Dissatisfaction; 0 = No) demonstrated the risk of occurring dissatisfaction among various characteristics, and continuous outcome (ranges from score 1 to 5) showed the degree. The mean score of dissatisfaction was 2.73 ± 1.08. Sixteen percent of rural participants and 19% of urban participants reported dissatisfaction with local medical services, respectively. The multilevel analyses demonstrated that participants' utilization of paid family doctor services decreased the risk of occurring dissatisfaction; dissatisfaction was less focused on females; having chronic diseases increased the risk of dissatisfaction. This study suggests promotion of family doctor services can effectively reduce middle-aged and elderly dissatisfaction with the local medical services. In addition, more attention should be focused on males and middle-aged and elderly with chronic diseases in order to decrease dissatisfaction.
随着中国医患暴力冲突的加剧，患者的不满已成为当前中国医疗改革的主要关注点。本研究旨在调查导致中年和老年人群不满当地医疗服务的主要决定因素，并确定需要改进的领域。本研究共纳入了来自 2018 年中国健康与退休纵向研究的 14263 名农村参与者和 4898 名城市参与者。不满通过两种方法进行衡量：二元结果（1=不满意；0=满意）表示各种特征下发生不满的风险，连续结果（评分范围为 1 到 5）表示不满的程度。不满的平均得分为 2.73±1.08。分别有 16%的农村参与者和 19%的城市参与者对当地医疗服务不满意。多水平分析表明，参与者使用付费家庭医生服务的比例降低了发生不满的风险；女性不满的情况较少；患有慢性病会增加不满的风险。本研究表明，推广家庭医生服务可以有效降低中年和老年人群对当地医疗服务的不满。此外，应更加关注男性和患有慢性病的中年和老年人群，以减少不满。
