Article Text
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
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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.