Determinants and influencing mechanism of outpatient satisfaction: a survey on tertiary hospitals in the People’s Republic of China

Figures & data

Table 1 Factors related to patient satisfaction based on literature studies

Category	Factor
Patient	Sociodemographic characteristics
	Disease
	Medical needs and education
	Access to medical information
	Participation in decision making
	Medical costs
Medical staff
Doctors	Diagnosis and treatment process
	Medical technology
	Communication skills
	Service attitudes
Nurses	Quality of nursing care
	Service attitudes
	Length of work time
Doctor–patient relationship	Doctor–patient relations
	Medical care quality
	Doctor–patient interaction
Medical environment	Waiting time
	Hospital environment
	Accessibility to medical services
	Hospital characteristics

Table 2 Sociodemographic characteristics of outpatients

Sociodemographic characteristics	N (%)
Sex
Male	439 (45.2)
Female	532 (54.8)
Occupation
Student	106 (10.9)
Worker	160 (16.5)
Farmer	74 (7.6)
Retiree	211 (21.7)
Civil servant	79 (8.1)
Medical staff	46 (4.7)
Military personnel	19 (2.0)
Other	276 (28.4)
Age (years)
<20	70 (7.2)
20–29	223 (23.0)
30–39	237 (24.4)
40–49	175 (18.0)
50–59	153 (15.8)
≥60	113 (11.6)
Monthly income (RMB)
<2,000	198 (30.7)
2,000–4,999	475 (48.9)
5,000–7,999	142 (14.6)
8,000–9,999	34 (3.5)
≥10,000	22 (2.3)
Residence
Shanghai	608 (62.6)
Other areas of the People’s Republic of China	357 (36.8)
Abroad	6 (0.6)
Marital status
Married	212 (21.8)
Single	720 (74.2)
Divorced	24 (2.5)
Widowed	15 (1.5)

Table 3 Univariate and bivariate analysis between sociodemographic characteristics and all satisfaction scales

Sociodemographic characteristics	Overall satisfaction	Satisfaction with doctors				Satisfaction with nurses		Satisfaction with other factors
		Service attitudes	Diagnosis and treatment time	Medical needs	Prescription	Prediagnosis counters	Waiting room	Hospital environment	Medical costs	Waiting time
Satisfaction, mean (SD)	4.0 (0.7)	4.2 (0.7)	4.1 (0.8)	4.0 (0.8)	4.0 (0.748)	4.2 (0.8)	4.2 (0.8)	3.9 (0.8)	3.7 (0.9)	3.7 (0.8)
Sex, χ^2 (P)	18.7 (0.0)*	20.1 (0.0)*	18.0 (0.0)*	22.0 (0.0)*	38.8 (0.0)*	16.7 (0.0)*	21.6 (0.0)*	20.3 (0.0)*	26.7 (0.0)*	13.7 (0.0)*
Male, mean (SD)	4.1 (0.8)	4.3 (0.8)	4.2 (0.9)	4.1 (0.9)	4.2 (0.8)	4.3 (0.8)	4.3 (0.8)	4.1 (0.8)	3.9 (1.0)	3.8 (0.9)
Female, mean (SD)	3.9 (0.7)	4.1 (0.7)	4.0 (0.7)	3.9 (0.7)	3.9 (0.7)	4.1 (0.7)	4.1 (0.7)	3.8 (0.7)	3.6 (0.8)	3.6 (0.7)
Occupation, χ^2 (P)	37.1 (0.0)*	30.0 (0.0)*	26.2 (0.0)*	26.7 (0.0)*	36.0 (0.0)*	25.6 (0.0)*	27.7 (0.0)*	21.4 (0.0)*	44.5 (0.0)*	36.9 (0.0)*
Student, mean (SD)	4.0 (0.8)	4.3 (0.8)	4.0 (0.8)	4.1 (0.8)	4.1 (0.8)	4.1 (0.8)	4.2 (0.8)	4.1 (0.8)	3.8 (0.9)	3.7 (0.9)
Worker, mean (SD)	3.8 (0.8)	4.1 (0.7)	4.0 (0.8)	3.9 (0.8)	3.9 (0.8)	4.1 (0.8)	4.1 (0.8)	3.9 (0.7)	3.5 (0.9)	3.6 (0.8)
Farmer, mean (SD)	4.4 (0.7)	4.1 (0.7)	4.1 (0.7)	4.0 (0.9)	4.0 (0.7)	4.0 (0.8)	4.0 (0.8)	3.8 (0.8)	3.4 (0.8)	3.5 (0.8)
Retiree, mean (SD)	4.0 (0.6)	4.1 (0.7)	4.1 (0.7)	4.0 (0.7)	4.1 (0.7)	4.1 (0.7)	4.1 (0.7)	3.9 (0.8)	3.8 (0.7)	3.6 (0.8)
Civil servant, mean (SD)	4.1 (0.9)	4.3 (0.8)	4.2 (0.9)	4.2 (0.8)	4.2 (0.9)	4.3 (0.8)	4.4 (0.8)	4.8 (0.6)	4.0 (0.9)	3.9 (0.9)
Medical staff, mean (SD)	4.9 (0.4)	4.5 (0.7)	4.5 (0.7)	4.3 (0.4)	4.4 (0.7)	4.6 (0.7)	4.5 (0.8)	4.3 (0.9)	4.1 (1.1)	4.2 (0.9)
Military personnel, mean (SD)	3.9 (0.9)	4.1 (0.8)	4.2 (0.7)	4.2 (0.7)	4.0 (0.7)	4.4 (0.7)	4.4 (0.7)	3.8 (0.8)	4.1 (0.8)	3.8 (1.0)
Other, mean (SD)	3.9 (0.7)	4.1 (0.7)	4.0 (0.8)	3.9 (0.7)	3.9 (0.7)	4.1 (0.7)	4.1 (0.8)	3.9 (0.7)	3.6 (0.8)	3.6 (0.8)
Age, r (P)	0.0 (0.3)	0.0 (0.9)	0.0 (0.1)	0.0 (0.2)	0.0 (1.1)	0.0 (0.4)	20.0 (0.4)	0.0 (0.5)	0.0 (0.2)	0.0 (0.2)
<20 years, mean (SD)	4.8 (0.7)	4.3 (0.7)	4.1 (0.9)	4.1 (0.8)	4.1 (0.8)	4.2 (0.8)	4.3 (0.8)	4.2 (0.8)	3.9 (0.9)	3.8 (0.9)
20–29 years, mean (SD)	3.9 (0.7)	4.1 (0.8)	4.0 (0.8)	3.9 (0.8)	4.0 (0.7)	4.1 (0.8)	4.0 (0.8)	3.9 (0.7)	3.6 (0.9)	3.6 (0.8)
30–39 years, mean (SD)	3.9 (0.7)	4.0 (0.7)	4.0 (0.8)	4.0 (0.8)	4.0 (0.7)	4.2 (0.8)	4.2 (0.8)	3.9 (0.8)	3.6 (0.9)	3.6 (0.8)
40–49 years, mean (SD)	3.9 (0.8)	4.2 (0.7)	4.1 (0.8)	4.0 (0.8)	4.0 (0.8)	4.2 (0.7)	4.1 (0.8)	3.9 (0.8)	3.8 (0.8)	3.7 (0.8)
50–59 years, mean (SD)	4.0 (0.7)	4.2 (0.7)	4.1 (0.8)	4.0 (0.8)	4.1 (0.7)	4.2 (0.8)	4.2 (0.8)	3.9 (0.9)	3.8 (0.9)	3.7 (0.8)
≥60 years, mean (SD)	4.7 (0.6)	4.2 (0.7)	4.2 (0.7)	4.2 (0.8)	4.1 (0.8)	4.2 (0.8)	4.2 (0.7)	4.1 (0.8)	3.7 (0.8)	3.7 (0.9)
Monthly income, r (P), (RMB)	0.0 (0.3)	0.0 (0.6)	0.0 (0.4)	0.0 (0.9)	0.0 (0.4)	0.1 (0.1)	0.0 (0.2)	0.0 (0.5)	0.1 (0.1)	0.0 (0.2)
<2,000, mean (SD)	3.9 (0.7)	4.2 (0.7)	4.0 (0.8)	4.0 (0.8)	4.1 (0.7)	4.1 (0.8)	4.1 (0.8)	3.9 (0.8)	3.6 (0.9)	3.6 (0.9)
2,000–4,999, mean (SD)	4.0 (0.7)	4.1 (0.7)	4.1 (0.8)	4.0 (0.8)	4.0 (0.7)	4.2 (0.7)	4.2 (0.8)	3.9 (0.8)	3.8 (0.8)	3.7 (0.8)
5,000–7,999, mean (SD)	4.0 (0.7)	4.2 (0.7)	4.1 (0.8)	4.0 (0.8)	4.0 (0.8)	4.3 (0.7)	4.2 (0.8)	4.0 (0.8)	3.8 (0.9)	3.7 (0.8)
8,000–9,999, mean (SD)	3.9 (0.8)	4.1 (0.9)	4.1 (1.0)	3.9 (0.8)	3.9 (0.9)	4.3 (0.6)	4.2 (0.6)	4.0 (0.8)	3.5 (1.0)	3.8 (0.7)
≥100,000, mean (SD)	3.6 (0.9)	4.1 (1.0)	3.7 (0.9)	3.6 (1.0)	3.8 (1.0)	4.0 (1.0)	3.8 (1.0)	3.8 (0.8)	3.4 (1.0)	3.2 (1.1)
Residence, χ^2 (P)	48.0 (0.0)*	7.4 (0.0)*	7.5 (0.0)*	43.1 (0.0)*	11.7 (0.0)*	29.7 (0.0)*	6.8 (0.0)*	22.8 (0.0)*	14.3 (0.0)*	6.8 (0.0)*
Shanghai, mean (SD)	4.0 (0.7)	4.2 (0.7)	4.1 (0.8)	4.0 (0.8)	4.1 (0.7)	4.2 (0.8)	4.2 (0.8)	4.0 (0.8)	3.8 (0.9)	3.7 (0.9)
Other areas of the People’s	3.9 (0.7)	4.1 (0.7)	4.1 (0.8)	3.9 (0.8)	3.9 (0.8)	4.1 (0.7)	4.1 (0.7)	3.9 (0.8)	3.6 (0.8)	3.6 (0.8)
Republic of China, mean (SD)
Abroad, mean (SD)	3.0 (1.3)	3.2 (1.2)	3.0 (1.3)	3.2 (1.2)	3.2 (1.2)	3.2 (1.2)	3.2 (1.2)	2.8 (1.2)	3.5 (0.8)	3.0 (1.1)
Marital status, χ^2 (P)	1.1 (0.8)	6.4 (0.1)	6.8 (0.1)	3.2 (0.4)	9.1 (0.0)*	3.1 (0.4)	1.4 (0.7)	11.1 (0.0)*	3.3 (0.3)	4.5 (0.2)
Married, mean (SD)	4.0 (0.7)	4.2 (0.7)	4.1 (0.8)	4.0 (0.8)	4.1 (0.7)	4.2 (0.7)	4.2 (0.8)	3.9 (0.8)	3.7 (0.8)	3.7 (0.8)
Single, mean (SD)	4.0 (0.7)	4.2 (0.7)	4.1 (0.8)	4.0 (0.8)	4.1 (0.7)	4.1 (0.8)	4.2 (0.8)	4.0 (0.8)	3.7 (0.9)	3.7 (0.8)
Divorced, mean (SD)	3.7 (1.1)	3.8 (1.0)	3.5 (1.0)	3.7 (1.1)	3.5 (1.0)	3.8 (1.0)	3.9 (1.1)	3.5 (0.7)	3.3 (1.1)	3.4 (0.9)
Widowed, mean (SD)	3.8 (1.0)	3.9 (1.1)	3.9 (1.1)	3.6 (1.1)	3.6 (1.1)	4.1 (1.0)	4.0 (1.2)	3.7 (1.0)	3.7 (1.0)	3.3 (1.1)

Note:

* Indicates statistical significance.

Table 4 Logistic regression analysis of sociodemographic characteristics and outpatient satisfaction

Logistic regression analysis	Parameter	Estimate	95% Wald confidence limits		OR	95% Wald confidence limits
			Lower	Upper		Lower	Upper
Overall satisfaction	Sex	−0.5	−0.7	−0.2	0.6	0.5	0.8
	Medical staff	1.0	0.0	1.9	2.6	1.1	6.6
	2,000–4,999 RMB	0.9	0.0	1.7	2.4	1.1	5.6
	Shanghai	2.0	0.3	3.6	7.1	1.4	37.4
	Other areas of the	1.9	0.3	3.6	6.8	1.3	35.3
	People’s Republic of China
Satisfaction with doctors’ service attitudes	Sex	−0.5	−0.7	−0.2	0.6	0.5	0.8
	20–29 years old	−0.7	−1.4	−0.1	0.5	0.2	0.9
	30–39 years old	−0.7	−1.3	−0.1	0.5	0.3	0.9
	Shanghai	2.1	0.5	3.7	8.1	1.6	40.7
	Other areas of the	2.1	0.5	3.7	8.2	1.6	41.0
	People’s Republic of China
	Divorced	−0.9	−1.9	0.0	0.4	0.2	0.9
Satisfaction with diagnosis and treatment time	Sex	−0.5	−0.7	−0.2	0.6	0.5	0.8
	Medical staff	1.3	0.4	2.2	3.6	1.4	9.0
	20–29 years old	−0.8	−1.4	−0.1	0.5	0.2	0.9
	30–39 years old	−0.6	−1.2	0.0	0.5	0.3	0.9
	Shanghai	1.9	0.3	3.5	6.7	1.4	32.5
	Other areas of the	1.8	0.3	3.4	6.3	1.3	30.4
	People’s Republic of China
	Divorced	−1.4	−2.3	−0.5	0.3	0.1	0.6
Satisfaction with medical needs being et by doctors	Sex	−0.5	−0.7	−0.3	0.6	0.5	0.8
m	20–29 years old	−0.8	−1.5	−0.2	0.4	0.2	0.8
	30–39 years old	−0.7	−1.3	−0.1	0.5	0.3	0.9
	40–49 years old	−0.8	−1.4	−0.2	0.5	0.3	0.8
	50–59 years old	−0.6	−1.0	−0.1	0.6	0.4	0.9
	Unemployed	1.0	0.1	2.0	2.8	1.1	7.4
	2,000–4,999 RMB	1.0	0.2	1.9	2.8	1.2	6.5
	5,000–7,999 RMB	1.0	0.1	1.9	2.7	1.1	6.4
	Widowed	−1.1	−2.2	0.0	0.3	0.1	0.9
Satisfaction with prescription	Sex	−0.7	−1.0	−0.5	0.5	0.4	0.6
	Divorced	−1.2	−2.1	−0.2	0.3	0.1	0.8
Satisfaction with nurses at prediagnosis counters	Sex	−0.4	−0.7	−0.2	0.6	0.5	0.8
	Medical staff	1.5	0.6	2.5	4.7	1.8	12.0
	20–29 years old	−0.9	−1.5	−0.2	0.4	0.2	0.8
	40–49 years old	−0.6	−1.2	0.0	0.5	0.3	0.9
	Shanghai	1.8	0.2	3.4	6.2	1.3	30.3
	Other areas of the	1.8	0.3	3.4	6.3	1.3	30.8
	People’s Republic of China
Satisfaction with nurses in the waiting room	Sex	−0.5	−0.8	−0.3	0.6	0.5	0.8
	Medical staff	1.4	0.5	2.4	4.1	1.6	10.6
	20–29 years old	−1.0	−1.7	−0.3	0.4	0.2	0.7
	40–49 years old	−0.7	−1.2	−0.1	0.5	0.3	0.9
	Unemployed	1.0	0.0	1.9	2.7	1.0	6.9
	Shanghai	1.7	0.1	3.3	5.4	1.1	26.6
	Other areas of the	1.8	0.2	3.4	5.9	1.2	29.1
	People’s Republic of China
Satisfaction with hospital environment	Sex	−0.5	−0.8	−0.3	0.6	0.5	0.8
	20–29 years old	−1.3	−1.9	−0.6	0.3	0.1	0.5
	30–39 years old	−1.2	−1.8	−0.6	0.3	0.2	0.6
	40–49 years old	−1.3	−1.9	−0.7	0.3	0.2	0.5
	50–59 years old	−0.7	−1.2	−0.2	0.5	0.3	0.8
	8,000–9,999 RMB	1.1	0.0	2.1	2.9	1.1	8.1
	Shanghai	2.2	0.5	3.9	8.9	1.7	47.3
	Other areas of the	2.1	0.4	3.7	7.9	1.5	42.1
	People’s Republic of China
	Divorced	−1.2	−2.1	−0.3	0.3	0.1	0.8
Satisfaction with medical costs	Sex	−0.6	−0.8	−0.3	0.6	0.4	0.7
	Worker	−1.0	−1.8	−0.2	0.4	0.2	0.8
	2,000–4,999 RMB	0.9	0.0	1.8	2.5	1.1	6.1
Satisfaction with waiting time	Sex	−0.4	−0.6	−0.1	0.6	0.5	0.9
	Retiree	−1.1	−1.9	−0.2	0.9	0.1	0.8
	<20 years old	−1.0	−2.0	−0.1	0.5	0.1	0.9
	20–29 years old	−1.2	−1.8	−0.5	0.5	0.2	0.6
	30–39 years old	−1.1	−1.7	−0.5	0.5	0.2	0.6
	40–49 years old	−0.9	−1.5	−0.3	0.6	0.2	0.7
	2,000–4,999 RMB	1.0	0.1	1.8	2.0	1.1	6.2
	5,000–7,999 RMB	1.0	0.1	1.9	1.8	1.1	6.6
	8,000–9,999 RMB	1.2	0.2	2.3	2.0	1.2	9.5
Overall satisfaction and various satisfaction dimensions	Service attitudes of doctors	0.7	0.4	1.0	2.0	1.4	2.8
	Diagnosis and treatment time	0.4	0.1	0.7	1.4	1.1	2.0
	Medical needs being met by doctors	1.0	0.7	1.3	2.7	2.0	3.8
	Prescription	0.5	0.2	0.8	1.6	1.2	2.2
	Hospital environment	0.3	0.0	0.5	1.3	1.1	1.7
	Medical costs	0.7	0.4	0.9	1.9	1.5	2.4
	Waiting time	0.6	0.4	0.8	1.9	1.5	2.3

Abbreviations: RMB, renminbi; OR, odds ratio.