Comparison Of Expectations For Health Services Between Inpatients From Mental Health Department And Endocrinology Department In China

Figures & data

Table 1 Vignettes Used To Measure Patient Expectations

Domain Of Responsiveness	Vignettes
Prompt attention	[Xiao Wang] broke his leg. It took an hour to be driven to the nearest hospital. He was in pain but had to wait an hour for the surgeon and was arranged for operation on the next day.
Dignity	[Miss Zhang] went to a crowded clinic. No-one greeted her. She waited for 30 minutes when a nurse called to her for an examination behind a screen that separated the waiting area from the examination area.
Confidentiality	[Mr. Jiang] had his consultation in a private room. During the consultation, a nurse occasionally walked in and listened to the conversation. Sometimes she forgot to close the door so people in the waiting room could overhear parts of their conversation.
Communication	[Mr. Li] has been told that he has epilepsy and that he needs to take medication. The doctor has very briefly explained what the condition is. He is very busy and there is a queue of patients waiting to see him. [Mr. Li] would like to know more about what he has, but feels that there is no time to ask questions, so Mr. Li leaves the office.
Quality of basic amenities	[Uncle Ma] shared a hospital room with four other persons. There was a toilet for his ward located along the outside corridor. The room was cleaned once a week, was occasionally dusty, and had only one or two chairs for visitors.
Choice of provider	When the clinic is not busy, [Aunt Liao] can choose which doctor she sees. But most often it is busy and then she gets sent to whoever is free.
Autonomy	[Uncle Lei] had a broken arm. The doctor explained different ways of fixing it and then ordered some blood tests. [Uncle Lei] did not know why he needed blood tests and was worried until the doctor explained what they were for.
Social support	[Ms. Dong] gave birth in hospital. Her husband was permitted to visit her every morning and evening. [Ms. Dong] was able to contact her family and friends once a day.

Table 2 Sample Characteristics

	Patients From MHD (n=228)	Patients From ED n=158)	P-value
Socio-demographic characteristics
Age
18–40	136 (59.6)	28 (17.7)	<0.001
41–60	80 (35.1)	70 (44.3)
61–85	12 (5.3)	60 (38.0)
Gender
Male	105 (46.1)	80 (50.6)	0.376
Female	123 (53.9)	78 (49.4)
Place of residence*
Urban	131 (57.5)	97 (61.4)	0.369
Rural	81 (35.5)	49 (31.0)
Marital status*
Single	87 (38.2)	17 (10.8)	<0.001
Married/Cohabiting	126 (55.3)	128 (81.0)
Separated/Divorced/Widowed	13 (5.7)	13 (8.2)
Education*
≤Primary school	19 (8.3)	48 (30.4)	<0.001
Junior high school	60 (26.3)	38 (24.1)
Senior high school	56 (24.6)	38 (24.1)
≥University	92 (40.4)	34 (21.5)
Occupation*
Employed	86 (37.7)	51 (32.3)	<0.001
Retired	18 (7.9)	45 (28.5)
Student	31 (13.6)	4 (2.5)
Caring for family	16 (7.0)	10 (6.3)
Unemployed	76 (33.3)	45 (28.5)
Health insurance coverage
Yes	214 (93.9)	157 (99.4)	0.006
No	14 (6.1)	1 (0.6)
Clinical characteristics
Time from diagnosis*
≤5 years	169 (73.7)	82 (51.9)	<0.001
>5 years	52 (22.8)	68 (43.0)
Duration of treatment*
≤5 years	189 (82.9)	86 (54.4)	<0.001
>5 years	31 (13.6)	62 (39.2)
Admission in multi-hospitals last 3 years
Yes	71 (31.1)	78 (49.4)	<0.001
No	157 (68.9)	80 (50.6)

Notes: Data are shown as n (%). All P-values in the table were from Chi-squared tests. *There are missing data.

Table 3 Patient Expectations Based On Vignettes

Domains	Outcomes	Patients From MHD	Patients From ED	Z test	P-value
Prompt attention	Meeting expectation	70 (30.8)	40 (25.3)	1.191	0.234
	Below expectation	157 (57.1)	118 (42.9)
Dignity	Meeting expectation	112 (49.1)	67 (42.4)	1.303	0.193
	Below expectation	116 (50.9)	91 (57.6)
Confidentiality	Meeting expectation	82 (36.0)	67 (42.4)	1.270	0.205
	Below expectation	146 (64.0)	91 (57.6)
Communication	Meeting expectation	116 (50.9)	76 (48.1)	0.535	0.593
	Below expectation	112 (49.1)	82 (51.9)
Quality of basic amenities	Meeting expectation	57 (25.0)	18 (11.4)	3.550	0.000
	Below expectation	171 (75.0)	140 (88.6)
Choice of provider	Meeting expectation	130 (57.0)	97 (61.4)	0.857	0.392
	Below expectation	98 (43.0)	61 (38.6)
Autonomy	Meeting expectation	181 (79.4)	139 (88.5)	2.470	0.014
	Below expectation	47 (20.6)	18 (11.5)
Social support	Meeting expectation	185 (81.5)	127 (80.9)	0.149	0.881
	Below expectation	42 (18.5)	30 (19.1)

Notes: Data are shown as n (%). All P-values in the column were from Z test. Meeting expectation: expectation scores=3, 4, or 5. Below expectation: expectation scores=1 or 2.

Table 4 Univariate Logistic Regression Model For Patients’ Expectation Based On Vignettes In Quality Of Basic Amenities And Autonomy

Variables	Basic Amenities		Autonomy
	OR (95% CI)	P-value	OR (95% CI)	P-value
Inpatient department
ED	Ref		Ref
MHD	2.593 (1.459–4.608)	0.001	0.499 (0.277–0.897)	0.020
Age
18–40	Ref		Ref
41–60	0.455 (0.258–0.802)	0.006	0.637 (0.361–1.124)	0.120
61–85	0.331 (0.147–0.744)	0.007	2.525 (0.928–6.867)	0.070
Gender
Male	Ref		Ref
Female	0.996 (0.602–1.650)	0.989	1.058 (0.621–1.804)	0.835
Place of residence
Urban	Ref		Ref
Rural	1.272 (0.747–2.164)	0.376	0.987 (0.555–1.756)	0.965
Marital status
Single	Ref		Ref
Married/Cohabiting	0.492 (0.284–0.855)	0.012	0.739 (0.393–1.390)	0.348
Separated/Divorced/Widowed	1.000 (0.380–2.635)	1.000	1.292 (0.345–4.845)	0.704
Education level
≤Primary school	Ref		Ref
Junior high school	1.748 (0.771–3.962)	0.181	0.836 (0.357–1.959)	0.680
Senior high school	1.082(0.454–2.582)	0.859	1.308(0.521–3.284)	0.568
≥University	1.555 (0.702–3.444)	0.277	0.643 (0.290–1.425)	0.277
Occupation
Employed	Ref		Ref
Retired	0.845 (0.379–1.887)	0.682	1.581 (0.671–3.723)	0.295
Student	1.551 (0.648–3.714)	0.325	1.815 (0.589–5.594)	0.299
Caring for family	0.815 (0.258–2.573)	0.727	1.796 (0.501–6.437)	0.369
Unemployed	1.287 (0.700–2.366)	0.417	0.947 (0.510–1.756)	0.862
Health insurance coverage
Yes	Ref		Ref
No	2.908 (1.002–8.441)	0.050	0.545 (0.168–1.767)	0.312
Time from diagnosis
≤5 years	Ref		Ref
>5 years	0.370 (0.190–0.719)	0.003	1.210 (0.666–2.200)	0.531
Duration of treatment
≤5 years	Ref		Ref
>5 years	0.451 (0.227–0.899)	0.024	1.583 (0.784–3.195)	0.200
Admission in multi-hospitals last 3 years
Yes	Ref		Ref
No	1.540 (0.897–2.644)	0.118	0.667 (0.376–1.181)	0.165

Notes: Outcome 1=meeting expectation, 0=below expectation.

Table 5 Multivariate Logistic Regression Model For Patients’ Expectation Based On Vignettes In Quality Of Basic Amenities And Autonomy

Explanatory Variables	Quality Of Basic Amenities		Autonomy
	Odds Ratio (95% CI)	P-value	Odds Ratio (95% CI)	P-value
Inpatient department
ED	Ref		Ref
MHD	2.333 (1.259–4.323)	0.007	0.521 (0.272–0.997)	0.049
Age
18–40			Ref
41–60			0.532 (0.293–0.964)	0.038
61–85			1.653 (0.559–4.885)	0.364
Time from diagnosis
≤5 years	Ref
>5 years	0.465 (0.235–0.921)	0.028

Notes: Outcome 1=meeting expectation, 0=below expectation. Method of logistic regression: backward.