Patient Satisfaction with Community Health Service Centers as Gatekeepers and the Influencing Factors: A Cross-Sectional Study in Shenzhen, China

PLoS One. 2016 Aug 23;11(8):e0161683. doi: 10.1371/journal.pone.0161683. eCollection 2016.

Abstract

Purpose: Shenzhen is the first pilot city in China implementing the gatekeeper policy, with community health service (CHS) centers as the gatekeepers. We aim to investigate patient satisfaction with this policy and its influencing factors in Shenzhen.

Methods: 3,848 patients visiting eight CHS centers in Shenzhen of China between May 1 and July 28, 2013 were recruited. We interviewed them using a structured questionnaire to investigate their satisfaction with the gatekeeper policy of CHS. Multivariable logistic regression models were used to identify influencing factors.

Results: Of the respondents, 28.17%, 47.27% and 24.56% were satisfied with, neutral to, and not satisfied with the gatekeeper policy respectively. Patient satisfaction with this policy was found to be associated with education level, familiarity with the policy, referral experience, satisfaction with convenience of seeing a doctor, satisfaction with waiting time, satisfaction with medical facility, satisfaction with general medical practitioners' professional skill, and proportion of expense reimbursed.

Conclusions: Our investigation shows that patient satisfaction with the gatekeeper policy was low. To improve patient satisfaction, efforts should be made to increase the convenience of seeing a doctor in community, shorten waiting time, improve general medical practitioners' professional skill, and increase proportion of expense reimbursement.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • China
  • Community Health Centers*
  • Community Health Services* / methods
  • Cross-Sectional Studies
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Public Health Surveillance*
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • Workforce
  • Young Adult

Grants and funding

This study was supported by National Natural Science Foundation of China (NSFC, 71373090, “Study on the gatekeeper policy of CHS”) and the Fundamental Research Funds for the Central Universities, HUST 2015QN111.