A study on satisfaction with publicly financed health services in China.

BACKGROUND: With implementation of Chinese universal healthcare, the performance of urban and rural residents' healthcare and the degree of satisfaction with publicly financed health services have become a hot issue in assessing health reforms in China. An evaluation model of health services in community and evaluation indexes of health-system performance have been put forward in related researches. This study examines variation in satisfaction with publicly financed health services among urban and rural residents in five Chinese cities and assesses their determinants.

METHODS: The data are derived from a survey of 1198 urban and rural residents from five nationally representative regions concerning their perceptions of satisfaction with China's publicly financed health services. The respondents assessed their degree of satisfaction with publicly financed health services on a 5-point Likert scale. It is a kind of questionaire scale that features the answers for 1-5 points labeled very unsatisfied, unsatisfied, neither unsatisfied nor satisfied, satisfied and very satisfied linking to each factor or variable, where a score of 1 reflects the lowest degree of satisfaction and a score of 5 represents the highest degree. The logistic regression methods are used to identify the variables into its determining components.

RESULTS: The overall satisfaction degree representing satisfaction of all factors (variables) is 3.02, which is at the middle level of a 1-5 Likert scale, inferring respondents' neutral attitude to publicly financed health services. According to the correlation test, the factors with characteristic root greater than 0.5 are chosen to take the factor analysis and 12 extracted factors can explain 77.97% of original 18 variables' total variance. Regression analysis based on the survey data finds that health records, vaccinations, pediatric care, elder care, and mental health management are the main factors accounting for degree of satisfaction with publicly financed health services for both urban and rural residents.

CONCLUSIONS: What can be done to increase the degree of satisfaction with health services needs to be considered based on our findings. Regression analysis based on the survey data finds that health records, vaccinations, pediatric care, elder care, and mental health management are the main factors accounting for degree of satisfaction with publicly financed health services for both urban and rural residents. Therefore, with improvements in health records, timely vaccination, elder care for women or elder, pediatric care and major psychosis management, degree of satisfaction with publicly financed health services are likely to grow.