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Patient dissatisfaction in China: What matters

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  • Pan, Jay
  • Liu, Dan
  • Ali, Shehzad

Abstract

Patient satisfaction is a focal concern of health-care delivery and an expected outcome of medical care. Recently, the violent conflict between doctors and patients in China has intensified. Patient dissatisfaction has been recognized as an important concern and an urgent issue in the reform of China's health care. The objectives of this study are to investigate the determinants of patient dissatisfaction attributed to patient, hospital, and health-care market characteristics, as well as to explore the major determinants in the context of China. Data from 2007 to 2010 Urban Resident Basic Medical Insurance Survey (URBMIS) are used in this study. A total of 13,336 patients are selected conditional on health-care utilization. Analysis of satisfaction is based on outpatient utilization (last 2 weeks' reference, 6393 individuals) and inpatient utilization (last 1-year reference, 6943 individuals). Satisfaction was measured as ordinal variables (scales 1–5). Ordinary least squares (OLS) regression and an ordered probit model are applied to investigate the determinants. Blinder–Oaxaca decomposition is further employed to detect the proportion each predictor's contribution. The results indicate that patients' gender, education, and insurance status are significantly related to patient satisfaction. Higher-level hospitals are found to negatively correlate with patient satisfaction. Lower competition in providers' market and a higher market share of private hospitals are found to positively correlate with patient dissatisfaction. Meanwhile, the survey indicates that “medical charges too expensive” is chiefly responsible for patient dissatisfaction. Our study provides empirical evidence on the determinants of patient dissatisfaction in China. In particular, the results indicate that establishing a high competition among various providers in the health-care market will act as a “double-edged sword,” with great policy implications.

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  • Pan, Jay & Liu, Dan & Ali, Shehzad, 2015. "Patient dissatisfaction in China: What matters," Social Science & Medicine, Elsevier, vol. 143(C), pages 145-153.
    • Handle: RePEc:eee:socmed:v:143:y:2015:i:c:p:145-153
    DOI: 10.1016/j.socscimed.2015.08.051
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    3. Mudan Yan & Mengjia Zhi & Yue Xu & Linlin Hu & Yuanli Liu, 2022. "Inpatient Satisfaction with Nursing Care and Its Impact Factors in Chinese Tertiary Hospitals: A Cross-Sectional Study," IJERPH, MDPI, vol. 19(24), pages 1-12, December.
    4. Ning Liu & Zhuo Chen & Guoxian Bao, 2021. "Unpacking the red packets: institution and informal payments in healthcare in China," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(8), pages 1183-1194, November.
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    6. Linlin Hu & Bright P. Zhou & Shiyang Liu & Zijuan Wang & Yuanli Liu, 2019. "Outpatient Satisfaction with Tertiary Hospitals in China: The Role of Sociodemographic Characteristics," IJERPH, MDPI, vol. 16(19), pages 1-13, September.
    7. Yuping Li & Weijuan Gong & Xiang Kong & Olaf Mueller & Guangyu Lu, 2020. "Factors Associated with Outpatient Satisfaction in Tertiary Hospitals in China: A Systematic Review," IJERPH, MDPI, vol. 17(19), pages 1-29, September.
    8. Zhao, Chunjuan & Ma, Wen, 2020. "Patient resistance towards clinicians’ diagnostic test-taking advice and its management in Chinese outpatient clinic interaction," Social Science & Medicine, Elsevier, vol. 258(C).

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