The Research Of Medical Staff And Patients' Satisfaction Under The Background Of New Cooperative Medical Scheme Based On The Structural Equation Modeling

Objective: To study the satisfaction of medical staff and patients' satisfaction under the background of New Cooperative Medical Scheme(NCMS) in Ningxia Hui autonomous region. To research influencing factors and mechanism of action of patients' satisfaction and figure out how the medical staff's satisfaction working on patients' satisfaction through the empirical analysis based on the structural equation modeling. Providing data support for the sustainable development of New Cooperative Medical Scheme, strengthening hospital's management, improving patients' satisfaction and farmers' health level.Methods: Two-stage stratified random sampling method was used for the contextual inquire. There are 1037 patients were surveyed with the method of face to face asking. There are 1046 medical staffs were surveyed with the fill in the questionnaire. Satisfaction of the general situation and the questionnaire analysis of reliability and validity of using IBM V21.0 of SPSS statistical software, using IBM SPSS AMOS V21.0 statistical software construct structural equation model.Results: 1. Patients who participated in NCMS in Ningxia region have a satisfaction of 73.3% for have received medical service. There is statistically significant for the difference of satisfaction between the patients with different region, ethnic, age, cultural degree(P<0.05).2. Among medical staffs in Ningxia region at the county level and below have a satisfaction for 60.3%. There is statistically significant for difference of satisfaction between the staff with different region, gender, culture degree(P<0.05).3. The patient satisfaction questionnaire and medical staff satisfaction questionnaire have a higher reliability and validity. The Cronbach's alpha coefficient is 0.959 and 0.968. The cumulative variance contribution rate of designed dimension in questionnaire is 76.09% and 81.27%.4. The structural equation modeling for factors which have effect on patients' satisfaction has a better fitness. The results show that the evaluation of patients about hospital image has significantly positive effect on expect perception with the standardized path coefficient for 0.627(P<0.05); the evaluation of hospital image and auxiliary service has significantly positive effect on patients value perception with standardized path coefficients for 0.347 and 0.406(P<0.05); the evaluation of patients expect perception, medical environment, ancillary services, medical services and value perception has significantly positive effect on patients' satisfaction, the standardized path coefficient are 0.223, 0.127, 0.180, 0.099, 0.464(P<0.05).5. The empirical model of medical staffs' of satisfaction effecting on patients' satisfaction has a better fitness. The effect of the medical staffs' satisfaction on patient satisfaction has significantly direct affects with the positive effect value of 0.322(P<0.05). Quality perceiving and price perception of patients are significantly indirect effect on patients' satisfaction with positive indirect effect value of 0.332(P<0.05).Conclusion: 1. Patients who participated in NCMS in Ningxia region have a higher overall satisfaction for have received medical service. The patients in Guyuan, Hui ethnic, age between 55 and 64, lower cultural degree have a higher satisfaction.2. Medical staffs in Ningxia region at the county level and below have an average satisfaction. The staffs with the character of Wuzhong, male have higher satisfaction, but who have higher culture degree have lower satisfaction.3. The patients' expect perception, value perception and evaluation of hospital environment, ancillary services and medical services have direct effects on patients' satisfaction. Ancillary medical services through value perception have indirect effects on patient satisfaction. Hospital image would not able to direct effects on patient satisfaction, but have indirect effects on patients' satisfaction through patient expect perception, value perception. The biggest impact on patients' satisfaction is price perception, followed by the auxiliary services.4. Medical staffs' satisfaction can not only directly affect patient satisfaction, but also indirectly affect patients' satisfaction through patients' quality perception and perception price impacts. The improvement of medical staffs' satisfaction can drive the improvement of patients' satisfaction.