Patient experience of hospital care in China: major findings from the Chinese Patient Experience Questionnaire Survey (2016-2018)
Patient experience of hospital care in China: major findings from the Chinese Patient Experience Questionnaire Survey (2016-2018)
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DOI：
10.1136/bmjopen-2019-031615
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发表时间：
2019-09-01
期刊：
影响因子：
2.9
通讯作者：
Liu, Yuanli
中科院分区：
文献类型：
--
作者：
Hu, Guangyu;Chen, Yin;Liu, Yuanli
中国于2015年启动了国家医疗保健改善计划（NHII），以改善患者的医疗保健体验。本研究的目的是从患者的角度产生医院护理质量的证据。设计这项全国性的横断面研究采访了来自31个省的参与者，研究对象为中国大陆117家三级医院，门诊患者48422人，住院患者35957人。主要结局指标：结果80%以上的被调查者认为自己的护理经历是积极的，而80%以上的被调查者认为自己的护理经历是积极的。NHII似乎产生了积极的影响，正如2016-2018年期间患者体验评分的稳步增长所表明的那样。中国患者普遍报告了积极的临床护理体验，但报告了较少的环境，人际和社会服务方面的护理积极的经验。影响中国患者就医体验的因素有机构因素（地区和医院类型）和个人因素（性别、年龄、教育程度和职业）。人文关怀的护理方面与整体患者的经验rating在门诊和住院settings.Conclusions的全国调查表明，在中国的护理整体积极的病人的角度最大的关联。研究发现，年龄较大、教育水平较高和正规就业状况与积极的护理经验相关，该区域经济发展水平较高、保险福利更慷慨以及护理协调程度更高也是如此。人际相关的举措在改善患者体验方面发挥了重要作用。在农民和中医药服务使用者占人口比例较大的地区，改善这些群体的患者体验值得特别关注。
Objectives China launched the National Healthcare Improvement Initiative (NHII) in 2015 to improve patient experiences in healthcare. This study aimed to generate evidence of hospital care quality from the patients' perspective.Design This nationwide cross-sectional study interviewed participants from 31 provinces, municipalities and autonomous regions across China.Setting A total of 117 tertiary hospitals in mainland China.Participants 48 422 responses from outpatients and 35 957 responses from inpatients were included in this study.Primary outcome measure The scores of six predefined domains in the Chinese Patient Experience Questionnaire, five of which were designed to reflect specific dimensions of care, and one of which indicated the overall rating.Results More than 80% of the respondents viewed their care experiences as positive. The NHII seems to have had a positive impact, as indicated by the steady, although unremarkable, increase in the patient experience scores over the 2016-2018 period. The Chinese patients generally reported a positive experience with the clinical aspects of care, but reported a less positive experience with the environmental, interpersonal and social services aspects of care. The institutional factors, including region and type of hospital, and personal factors, such as gender, age, education and occupation, were factors affecting the patient experience in China. Humanistic care was the aspect of care with the greatest association with the overall patient experience rating in both the outpatient and inpatient settings.Conclusions The national survey indicated an overall positive patient perspective of care in China. Older age, higher education level and formal employment status were found to be correlated with positive care experiences, as were higher levels of economic development of the region, a more generous insurance benefits package and a higher degree of coordinated care. The interpersonal-related initiatives had substantial roles in the improvement of the patient experience. In the regions where farmers and users of traditional Chinese medicine services constitute a greater proportion of the population, improvement of patient experiences for these groups deserves special policy attention.