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Health services research
Original research
Patient experience of hospital care in China: major findings from the Chinese Patient Experience Questionnaire Survey (2016–2018)
  1. Guangyu Hu1,2,
  2. Yin Chen3,
  3. Qiannan Liu4,
  4. Shichao Wu2,
  5. Jing Guo2,
  6. Shiyang Liu2,
  7. Zijuan Wang2,
  8. Pengyu Zhao2,
  9. Jing Sun2,
  10. Linlin Hu2,
  11. Huixuan Zhou2,
  12. Li Luo5,
  13. Ying Mao6,
  14. Jack Needleman7,
  15. Jing Ma8,
  16. Yuanli Liu2
  1. 1 Institute of Medical Information/Center for Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  2. 2 School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
  3. 3 Peking University International Hospital, Beijing, China
  4. 4 National Institute of Hospital Administration, Beijing, China
  5. 5 School of Public Health, Fudan University, Shanghai, China
  6. 6 School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
  7. 7 Department of Health Policy and Management, Fielding School of Public Health, UCLA, Los Angeles, California, USA
  8. 8 Department of Population Medicine, Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Professor Jing Ma; jing_ma{at}harvardpilgrim.org; Professor Yuanli Liu; liuyl_fpo{at}126.com

Abstract

Objectives 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.

Design This nationwide cross-sectional study interviewed participants from 31 provinces, municipalities and autonomous regions across China.

Setting A total of 117 tertiary hospitals in mainland China.

Participants 48 422 responses from outpatients and 35 957 responses from inpatients were included in this study.

Primary outcome measure 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.

Results 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.

Conclusions 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.

  • patient experience
  • quality in healthcare
  • health policy

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-031615

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    Footnotes

    • Contributors Conceptualisation: YL. Data curation: GH, YC, QL, SW, JG, SL, ZW and PZ. Formal analysis: GH. Funding acquisition: YL and GH. Investigation: GH, YC, QL, SW, JG, SL, ZW, PZ, JS and LH. Methodology: YL and GH. Project administration: GH, JS, LH and HZ. Resources: LL, YM and JM. Software: GH. Supervision: JM and YL. Visualization: GH. Writing—original draft: GH, YC, QL and SL. Writing—review and editing: JN, JM and YL.

    • Funding This research was funded by the Bureau of Medical Administration of National Health Commission, PR China; the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2018PT33009) and the Special Research Fund for Central Universities, Peking Union Medical College (3332019087).

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Ethics approval The study was approved by the institutional review board of the Peking Union Medical College (71532014). All respondents provided their oral consent to participate in the survey before the interview.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data are available upon reasonable request.