Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China
Abstract Background In rural China, patients have free choice of health facilities for outpatient services. Comparison studies exploring the attributes of different health facilities can help identify optimal primary care service models. Using a representative sample of Chinese provinces, this study...
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| Format: | Article |
| Language: | English |
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BMC
2017-10-01
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| Series: | International Journal for Equity in Health |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12939-017-0672-1 |
| _version_ | 1818350132399177728 |
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| author | Wenhua Wang Elizabeth Maitland Stephen Nicholas Ekaterina Loban Jeannie Haggerty |
| author_facet | Wenhua Wang Elizabeth Maitland Stephen Nicholas Ekaterina Loban Jeannie Haggerty |
| author_sort | Wenhua Wang |
| collection | DOAJ |
| description | Abstract Background In rural China, patients have free choice of health facilities for outpatient services. Comparison studies exploring the attributes of different health facilities can help identify optimal primary care service models. Using a representative sample of Chinese provinces, this study aimed to compare patients’ rating of three primary care service models used by rural residents (public clinics, public hospitals and private clinics) on a range of health care attributes related to responsiveness. Methods This was a secondary analysis using the household survey data from World Health Organization (WHO) Study on global AGEing and adult health (SAGE). Using a multistage cluster sampling strategy, eight provinces were selected and finally 3435 overall respondents reporting they had visited public clinics, public hospitals or private clinics during the last year, were included in our analysis. Five items were used to measure patient perceived quality in five domains including prompt attention, communication and autonomy, dignity and confidentiality. ANOVA and Turkey’s post hoc tests were used to conduct comparative analysis of five domains. Separate multivariate linear regression models were estimated to examine the association of primary care service models with each domain after controlling for patient characteristics. Results The distribution of last health facilities visited was: 29.5% public clinics; 31.2% public hospitals and; 39.3% private clinics. Public clinics perform best in all five domains: prompt attention (4.15), dignity (4.17), communication (4.07), autonomy (4.05) and confidentiality (4.02). Public hospitals perform better than private clinics in dignity (4.03 vs 3.94), communication (3.97 vs 3.82), autonomy (3.92 vs 3.74) and confidentiality (3.94 vs 3.73), but equivalently in prompt attention (3.92 vs 3.93). Rural residents who are older, wealthier, and with higher self-rated health status have significantly higher patient perceived quality of care in all domains. Conclusions Rural public clinics, which share many characteristics with the optimal primary care delivery model, should be strongly strengthened to respond to patients’ needs. Better doctor-patient interaction training would improve respect, confidentiality, autonomy and, most importantly, health care quality for rural patients. |
| first_indexed | 2024-12-13T18:16:59Z |
| format | Article |
| id | doaj.art-64abc47b32ea4bd5adc1ace9c4dbffeb |
| institution | Directory Open Access Journal |
| issn | 1475-9276 |
| language | English |
| last_indexed | 2024-12-13T18:16:59Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal for Equity in Health |
| spelling | doaj.art-64abc47b32ea4bd5adc1ace9c4dbffeb2022-12-21T23:35:49ZengBMCInternational Journal for Equity in Health1475-92762017-10-011611910.1186/s12939-017-0672-1Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural ChinaWenhua Wang0Elizabeth Maitland1Stephen Nicholas2Ekaterina Loban3Jeannie Haggerty4School of Health Sciences, Wuhan UniversitySchool of Management, Australian School of Business, University of New South WalesSchool of Management and Commerce, Tianjin Normal UniversityDepartment of Family Medicine, McGill UniversityDepartment of Family Medicine, McGill UniversityAbstract Background In rural China, patients have free choice of health facilities for outpatient services. Comparison studies exploring the attributes of different health facilities can help identify optimal primary care service models. Using a representative sample of Chinese provinces, this study aimed to compare patients’ rating of three primary care service models used by rural residents (public clinics, public hospitals and private clinics) on a range of health care attributes related to responsiveness. Methods This was a secondary analysis using the household survey data from World Health Organization (WHO) Study on global AGEing and adult health (SAGE). Using a multistage cluster sampling strategy, eight provinces were selected and finally 3435 overall respondents reporting they had visited public clinics, public hospitals or private clinics during the last year, were included in our analysis. Five items were used to measure patient perceived quality in five domains including prompt attention, communication and autonomy, dignity and confidentiality. ANOVA and Turkey’s post hoc tests were used to conduct comparative analysis of five domains. Separate multivariate linear regression models were estimated to examine the association of primary care service models with each domain after controlling for patient characteristics. Results The distribution of last health facilities visited was: 29.5% public clinics; 31.2% public hospitals and; 39.3% private clinics. Public clinics perform best in all five domains: prompt attention (4.15), dignity (4.17), communication (4.07), autonomy (4.05) and confidentiality (4.02). Public hospitals perform better than private clinics in dignity (4.03 vs 3.94), communication (3.97 vs 3.82), autonomy (3.92 vs 3.74) and confidentiality (3.94 vs 3.73), but equivalently in prompt attention (3.92 vs 3.93). Rural residents who are older, wealthier, and with higher self-rated health status have significantly higher patient perceived quality of care in all domains. Conclusions Rural public clinics, which share many characteristics with the optimal primary care delivery model, should be strongly strengthened to respond to patients’ needs. Better doctor-patient interaction training would improve respect, confidentiality, autonomy and, most importantly, health care quality for rural patients.http://link.springer.com/article/10.1186/s12939-017-0672-1Primary care qualityPatient experiencePatient responsivenessAccessibilityInterpersonal communicationRespectfulness |
| spellingShingle | Wenhua Wang Elizabeth Maitland Stephen Nicholas Ekaterina Loban Jeannie Haggerty Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China International Journal for Equity in Health Primary care quality Patient experience Patient responsiveness Accessibility Interpersonal communication Respectfulness |
| title | Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China |
| title_full | Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China |
| title_fullStr | Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China |
| title_full_unstemmed | Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China |
| title_short | Comparison of patient perceived primary care quality in public clinics, public hospitals and private clinics in rural China |
| title_sort | comparison of patient perceived primary care quality in public clinics public hospitals and private clinics in rural china |
| topic | Primary care quality Patient experience Patient responsiveness Accessibility Interpersonal communication Respectfulness |
| url | http://link.springer.com/article/10.1186/s12939-017-0672-1 |
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