Patient experiences with inpatient care in rural China

Abstract

Objective: To describe patient experiences with hospital inpatient care among participants living in rural China and to examine their associations with sociodemographic characteristics, hospital type and province.

Design: Cross-sectional study using data from questionnaires administered to members of randomly selected households in 2010. We used linear and logistic regression to determine associations between patient ratings of care and key components of their experience and between patient ratings of care and sociodemographic characteristics, hospital type and province.

Setting: Households located in seven provinces in rural China.

Participants: Household members >15 years who reported being admitted to the hospital within the last 365 days with valid data on our outcome measures (n = 443).

Main outcome measures: Patient evaluations of health care experiences.

Results: Approximately 31% of participants rated their experiences 5.0 out of 5.0 (best), but 22% rated their experiences ≤3.0. Fifteen percent would not recommend the facility to family and friends. Five factors emerged, of which, 'communication with nurses' was most strongly and consistently associated with overall patient ratings. Multivariable models showed that ratings for township and county-level hospitals were significantly lower than above county-level hospitals. Variation also existed across the seven provinces.

Conclusions: Findings suggest that patients on average have high ratings of hospital care, but a notable proportion of participants, particularly those receiving care in county-level hospitals, continue to be less than fully satisfied. As China further develops its health system, establishing routine monitoring of patients' experiences will be important to ensure the system is responsive to the population needs.

Keywords: China; hospital care; patient experiences; quality improvement.