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Public satisfaction with the healthcare system in China during 2013-2015: a cross-sectional survey of the associated factors.

ABSTRACT: OBJECTIVE:We explore how public satisfaction with the healthcare system in China varies with social and economic factors, especially regional variations and changes during 2013-2015. DESIGN:Population-based, cross-sectional survey performed between July 2013 and July 2015. SETTING:General population of China during 2013-2015. PARTICIPANTS:A total of 15?969 participants (women=49.4%, sample-weighted average age=51.9). PRIMARY OUTCOME MEASURE:Public satisfaction with the healthcare system, defined as 'being satisfied' if a respondent's satisfaction score is ?70 points. RESULTS:The 2-year mean of the satisfaction score of the sample is 68.5 out of 100 points and the score in 2015 is higher than 2013 by 3.5 points. Senior respondents (OR=1.19, p<0.001), rural respondents (OR=1.23, p=0.009) and those with higher socioeconomic status are more likely to report being satisfied. Internal migrants (OR=0.75, p<0.001) and those with a higher level of education are less likely to report being satisfied. Total health expenditure as percentage of gross domestic product and density of hospital beds have a significantly positive association with satisfaction (OR=1.13, p<0.001). Meanwhile, the government's share in total healthcare expenditures has a moderately negative association with satisfaction (OR=0.97, p<0.001). In rural areas, the density of hospital beds has a positive association with satisfaction (OR=1.26, p=0.002). The Northeast region and Shanghai (OR=0.49, p<0.001; OR=0.71, p=0.034) are less likely to report being satisfied and this remained unchanged in 2015. CONCLUSION:There are considerable disparities in public satisfaction with the healthcare system in China, associated with demographic and socioeconomic characteristics, regional locations, urban-rural environment, and regional health resource abundance. Actions are recommended to improve satisfaction with the public healthcare system, especially in the Northeast region of China.

SUBMITTER: Zhang JH

PROVIDER: S-EPMC7259843 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Public satisfaction with the healthcare system in China during 2013-2015: a cross-sectional survey of the associated factors.

Zhang Jing Hua JH Peng Xinxin X Liu Chengkun C Chen Yijun Y Zhang Hongmin H Iwaloye Ojo Olukayode OO

BMJ open 20200527 5

<h4>Objective</h4>We explore how public satisfaction with the healthcare system in China varies with social and economic factors, especially regional variations and changes during 2013-2015.<h4>Design</h4>Population-based, cross-sectional survey performed between July 2013 and July 2015.<h4>Setting</h4>General population of China during 2013-2015.<h4>Participants</h4>A total of 15 969 participants (women=49.4%, sample-weighted average age=51.9).<h4>Primary outcome measure</h4>Public satisfaction ...[more]

PMID: 32467252

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Project description:BackgroundLow risk pregnancy ending in a vaginal birth is best served and guided by a midwife. Utilizing a midwife in such cases offers many emotional and economic advantages and does not increase the risks for mother or neonate. However, women's experience and satisfaction of midwife-led maternity care is rarely reported in China. The primary objective of this study is to describe the experience of Chinese women receiving midwife-led maternity care, and to report their satisfaction level of the experience.MethodsThe study is a cross-sectional survey of 4192 women who had natural birth from March-June 2019 in a maternity care center, Shanghai, China. We used a self-administered questionnaire addressing items related to women's experience during childbirth, as well as their satisfaction with midwife-led maternity care. We also included demographic and perinatal characteristics of each participant. Descriptive statistics and correlations analysis between groups of different experience and satisfaction were used.ResultsIn this sample, 87.7% of women had a Doula and a family member present during childbirth. Epidural anesthesia was used in 75.6% and episiotomy was needed in 23.2%. Free positioning during the first stage of labor and free positioning during the second stage of labor and delivery were adopted in 84.3 and 67.9% of the cases, respectively. Moderate to severe perineal pain and moderate to severe perineal edema were reported in 43.1 and 12.2% of the participants, respectively. High satisfaction level was found when there was midwife-led prenatal counseling and presence of Doula and family member, Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during the first stage of labor, and midwifes' postpartum guidance. Negative satisfaction was seen with perineal pain and edema.ConclusionWomen in this survey generally had high satisfaction with midwife-led maternity care. This satisfaction is probably felt because of the prenatal counseling by the midwife and allowing a Doula and a family member in the room during childbirth. Other intangible factors to improve the satisfaction level were Lamaze breathing techniques, warm perineal compresses, epidural anesthesia, free positioning during first stage of labor, and early skin to skin contact.

Project description:The Internet hospital, an innovative approach to providing health care, is rapidly developing in China because it has the potential to provide widely accessible outpatient service delivery via Internet technologies. To date, China's Internet hospitals have not been systematically investigated.The aim of this study was to describe the characteristics of China's Internet hospitals, and to assess their health service capacity.We searched Baidu, the popular Chinese search engine, to identify Internet hospitals, using search terms such as "Internet hospital," "web hospital," or "cloud hospital." All Internet hospitals in mainland China were eligible for inclusion if they were officially registered. Our search was carried out until March 31, 2017.We identified 68 Internet hospitals, of which 43 have been put into use and 25 were under construction. Of the 43 established Internet hospitals, 13 (30%) were in the hospital informatization stage, 24 (56%) were in the Web ward stage, and 6 (14%) were in full Internet hospital stage. Patients accessed outpatient service delivery via website (74%, 32/43), app (42%, 18/43), or offline medical consultation facility (37%, 16/43) from the Internet hospital. Furthermore, 25 (58%) of the Internet hospitals asked doctors to deliver health services at a specific Web clinic, whereas 18 (42%) did not. The consulting methods included video chat (60%, 26/43), telephone (19%, 8/43), and graphic message (28%, 12/43); 13 (30%) Internet hospitals cannot be consulted online any more. Only 6 Internet hospitals were included in the coverage of health insurance. The median number of doctors available online was zero (interquartile range [IQR] 0 to 5; max 16,492). The median consultation fee per time was ¥20 (approximately US $2.90, IQR ¥0 to ¥200).Internet hospitals provide convenient outpatient service delivery. However, many of the Internet hospitals are not yet mature and are faced with various issues such as online doctor scarcity and the unavailability of health insurance coverage. China's Internet hospitals are heading in the right direction to improve provision of health services, but much more remains to be done.

Project description:BackgroundIntestinal helminth infections are a serious public health problem in developing countries. Jiangsu, an eastern coastal province of China, has an environment conducive to the transmission of intestinal parasites, and suffered human infection rates of 71.75% in 1990. Due to comprehensive anti-transmission measures undertaken throughout the province in the 1990s, the prevalence had decreased to 9.28% in 2002. In order to assess the current epidemic situation for intestinal parasitic infections in Jiangsu province, a province-wide cross-sectional survey was carried out in 2015.MethodsSurveys were conducted in two main settings; rural (for soil-transmitted parasites) and urban (for Clonorchis sinensis), selected through stratified random sampling. Human infection rates were evaluated through the detection of helminth eggs or cysts (oocysts or trophozoites) of intestinal protozoa in fecal samples by microscopy. Secondary intermediate and reservoir hosts were surveyed for C. sinensis infection. Questionnaires were completed by each participant to evaluate knowledge, attitude and practice of soil-transmitted parasite and C. sinensis avoidance.Results115 out of 30153 participants (0.38%) had intestinal helminths or protozoa. There were eight species of helminth detected and the most common parasite was the hookworm Ancylostoma duodenale. In rural settings, there were significant differences in infection rates between participants of differing economic status. In urban settings, only four cases of C. sinensis infection were detected. However, secondary intermediate and reservoir hosts were found to harbor parasites. The questionnaire survey revealed that 38.42% participants were not aware of how humans become infected by hookworms. Knowledge and awareness of C. sinensis was similarly low, with 53.22% participants combining the use of chopping boards for raw and cooked food items when preparing meals.ConclusionsThe prevalence of intestinal parasitic infections in Jiangsu Province in eastern China has decreased from 71.57% in 1990 to 0.38% in 2015. Control measures should now focus on parasitic infections in the elderly and in children, health promotion and the development of alternative detection methods.

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Public satisfaction with the healthcare system in China during 2013-2015: a cross-sectional survey of the associated factors.

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Public satisfaction with the healthcare system in China during 2013-2015: a cross-sectional survey of the associated factors.

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