The Survey On Residents’ Satisfaction Of Community Health Services In Guangzhou

Background:Community health service (CHS) is the best way to meet the needs of urban residentsfor basic health services. It is vital interesting to improve the development for the CHS, forit can provide a convenient method for the medical treatment, reduce the cost burden, andto establish a harmonious doctor-patient relationship. The service quality of the CHS isdirectly related to the health about their own self-interests of the residents. Deepening theconnotation of CHS is an important action to improve the quality of CHS, which hasbecome one of the key point work in Chinese CHS system. At the same time, promotingperformance appraisal is an effective measure to evaluate the quality of CHS. Satisfactionevaluation, an important part of performance appraisal, through which we may understandthe status of CHS and carry out well targeted measures, use a "customer visual angle" toexperience and assess quality of CHS.Objectives:The purpose of this survey was to understand the satisfaction of CHS of the residentsin Guangzhou City, and to understand the satisfaction of CHS of the people from differentsocial classes in the city, discover the main factors of the overall satisfaction of the CHS,and to provide scientific evidence for developing health policy to enhance CHS quality.Methods:Multi-stage sampling was used to this sampling survey. It was select55CHS centerswhich accounted for40%of all CHS centers in Guangzhou. Fifty residents living around each of the CHS center participated our investigation by convenience sampling method.The survey objects were divided into two parts, there were25-28residents assisted in theCHS center, and25-28people were from community activities places. People who wereolder than18years old and living around the CHS centers for more than1years wereincluded in the study. The investigation effective results out of2992residents were98.97%effective. Epidata3.1software was applied to code and input the survey data, SAS8.0software was applied to clean and analysis. Statistical methods included descriptivestatistical analysis, factor analysis, rank sum test, univariate and multivariate ordinalmultinomial logistic.Altogether19items (including hardware, software, and the cost of treatment) such asthe convenience for going to the center, tidy of environment, reasonable of see a doctor,waiting time, humanization of medical facilities, service price, the respecting for patients,responsibility, services attitude, patient’s self-determination on doctors, protection privacyof patients, communication between patients and doctors, providing knowledge of diseasesprevention, technology of medical, medical equipment, total treatment costs, trust indoctors, convenience of the complaint and the information publicity were analyzed in thepaper.Results:1. The overall satisfaction of residents was63.04%.2. In different age, cultural degree, occupation, working state and the means of paymentof medical cost residents service district health services to the general satisfaction hadsignificant difference.3. Amongst19items of hardware and software of CHS and the treatment costs, thesatisfaction of one item was higher than80%, the satisfaction of3items were70-79%, thesatisfaction of4items were60-69%, the satisfaction of6items were50-59%, thesatisfaction of5items were lower than50%. What items people most satisfactory (theirsatisfaction were higher than70%) were the respectively to the center of the convenience,the work sense of responsibility, services attitude and the respecting for patients, while mostdisatisfied (their satisfaction were lower than40%) were the respectively the complaints convenience, medical equipment and medical expenses.4. The result of Single factor ordinal multinomial logistic showed that,the satisfaction of residents to the19items have statistical significance. After controllingthe gender, age and education factors, there were also have statistical significance amongthe satisfaction of the convenience for going to the center, the tidy of environment,respecting patients, services attitude, responsibility, technology of medical, communicationbetween patients and doctors, trust in doctors, information publicity, reasonable of see adoctor and the treatment costs, the OR value were greater than1.5. Ordinal multinomial logistic regression analysis were applied to further analyzed thefive items which included the respecting for patients, responsibility, services attitude,technology of medical and the overall satisfaction of total costs. The result of the singlefactor ordinal multinomial logistic showed that the satisfaction of the first four items havestatistical significance.After controlling the gender, age and education factors, the result ofthe univariate and the multivariate ordinal multinomial logistic were same, their OR valueswere all bigger than1. The most important factor was the satisfaction of residents todoctors, and its OR value was future higher than that of the satisfaction of residents tonurses and other staffs. In addition, the influence that satisfaction of residents to theservices attitude of the registrars was just next to doctors; the result from a analysis in theoverall satisfaction of the treatment costs showed that the influence of medicine cost to theoverall satisfaction of total costs was far higher than examination fees and other costs.Conclusions:1. The overall satisfaction of residents about the CHS in this study was63.04%.Theconvenience for going to the center, responsibility, work attitude, and respecting patientshad a highly approval of the surveyed residents, but the satisfaction of the complaint,medical equipment and the information publicity were low.2. The convenience for going to the center, tidy environment, respecting patients, servicesattitude, responsibility, technology of medical, communication between patients anddoctors, trust in doctors and nurses, information publicity, reasonable and convenient of themedical treatment and the treatment costs were probably the main factors which influenced the overall satisfaction.3. According to the evaluation in respecting patients, services attitude, responsibility andthe medical technology were influenced greatly by the residents’ impression in the doctorsof the CHS. In addition to doctors, the satisfaction of the residents to the services attitude ofthe registrars was another important factor which affected the overall satisfaction. Thesatisfaction of residents to medical expenditure was largely dependent on the satisfaction ofmedication expenditure.In general, the CHS of Guangzhou city was generally approved by the surveyedresidents, but there were still certain gap compared with the expectation of the residents.The future quality of the CHS should be improved to meet the growing needs of theresidents.