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中国农村低收入成年人门诊服务满意度模式:潜在类别分析

Patterns of Outpatient Service Satisfaction among Low-Income Adults in Rural China: A Latent Class Analysis.

作者信息

Lu Peiyi, Yang Chunyu, Yao Jun, Xian Mingxia, Shelley Mack

机构信息

Departments of Political Science and Statistics, Iowa State University, Ames, IA 50011, USA.

College of Law and Political Science, Institute of Climate Change and Public Policy, Nanjing University of Information Science and Technology, Nanjing 210044, China.

出版信息

Healthcare (Basel). 2022 Jul 25;10(8):1380. doi: 10.3390/healthcare10081380.

Abstract

(1) Background: Low-income rural residents in China are disadvantaged due to their financial vulnerability and insufficient access to resources, and this situation demands more research effort. This study examined the pattern of outpatient service satisfaction and its determinants among low-income adults in rural China. (2) Methods: Rural low-income respondents who used outpatient services in their local healthcare facilities in Jiangsu, China evaluated the access, cost, environment, doctor-patient interaction, and other topics during their outpatient visit ( = 662). Latent class analysis was used to identify the groups characterized by various dimensions of outpatient satisfaction. Multinomial logistic regression explored the determinants of class membership. (3) Results: Three latent classes were identified: 28.70% had low satisfaction, unsatisfied with every dimension; 20.69% reported medium satisfaction that valued doctor-patient relationships; and 50.60% had high satisfaction but thought that costs were high. Both low and medium satisfaction were associated with a higher proportion of self-paid fees. (4) Conclusions: Healthcare costs were an important determinant of outpatient service satisfaction. Medical social workers are suggested to be included in the medical team to help patients identify financial assistance. Special aid programs may be developed to help relieve rural low-income patients' medical cost-related burden.

摘要

(1) 背景:中国农村低收入居民因经济脆弱性和资源获取不足而处于不利地位,这种情况需要更多的研究努力。本研究调查了中国农村低收入成年人的门诊服务满意度模式及其决定因素。(2) 方法:在中国江苏当地医疗机构使用门诊服务的农村低收入受访者在门诊就诊期间对就医便利性、费用、环境、医患互动等方面进行了评价(=662)。采用潜在类别分析来识别以门诊满意度不同维度为特征的群体。多项逻辑回归分析探讨了类别归属的决定因素。(3) 结果:确定了三个潜在类别:28.70% 的人满意度低,对各个维度都不满意;20.69% 的人报告中等满意度,重视医患关系;50.60% 的人满意度高,但认为费用高。低满意度和中等满意度都与较高的自费比例相关。(4) 结论:医疗费用是门诊服务满意度的重要决定因素。建议将医务社会工作者纳入医疗团队,以帮助患者确定经济援助。可以制定特别援助计划,以帮助减轻农村低收入患者与医疗费用相关的负担。

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