Prevalence and Influencing Factors of Medical Dissatisfaction Experiences in Chinese Hospitals: A Cross-Sectional Study

Figures & data

Table 1 The Classification of Influencing Factors of Medical Dissatisfaction Experiences

Variables	Description (Options)	Simplification	F1	F2	F3	F4
Social Relationships ((SR))	How did you think about the attitude people treated you in your daily life? ((1)Very disrespectful, (2) Fairly disrespectful, (3) General, (4) Fairly respectful, (5) Very respectful)	Social status cognition(X1)	0.717	−0.054	0.230	0.048
	How many friends can help or support you when you were in trouble? ((1) 0, (2) 1–2, (3) 3–5, (4) ≥6)	Degree of social support(X2)	0.662	0.183	−0.157	0.101
	How did you feel the relationship among your family members? ((1) Very disharmonious, (2) Fairly disharmonious, (3) General, (4),Fairly harmonious, (5) Very harmonious)	Family relationship(X3)	0.712	0.047	0.194	0.002
Health Education and Media Reports (HEMR)	Have you often seen reports on the behavior of health care workers (HCWs) or the doctor-patient relationship (DPR) in the media? ((1) Almost never, (2) Seldom, (3) Generally, (4) Often, (5) Almost always)	Frequency of contacting with media reports(X4)	0.086	0.833	−0.069	−0.051
	How often did you pay attention to or acquire knowledge related health care?((1) Almost never, (2) Seldom, (3) Generally, (4) Often (5) Almost always)	Frequency of getting the health education(X5)	0.059	0.845	0.032	0.034
Patients’ Cognition on Health Care Workers (PCHCWs)	In general, what did you think about the sense of responsibility of the current health care workers (HCWs)?((1) Very weak, (2),Fairly weak, (3),General, (4) Fairly strong, (5) Very strong)	Responsibility of HCWs.(Y1)	0.042	0.014	0.857	0.245
	In general, what did you feel the service attitude of the current health care workers (HCWs)?((1) Very bad, (2) Fairly bad, (3) General, (4) Fairly good, (5) Very good)	Service attitude of HCWs(Y2)	0.072	0.019	0.869	0.196
	In general, how much trust did you have in health care workers (HCWs)?((1) Very distrustful, (2) Fairly distrustful, (3) General, (4) Fairly trustful, (5) Very trustful)	Trust in HCWs(Y3)	0.139	−0.024	0.744	0.265
	In general, how did you evaluate the current doctor-patient relationship (DPR)?((1) Very bad, (2) Fairly bad, (3) General, (4) Fairly good, (5) Very good)	Doctor-patient relationship evaluation(Y4)	0.127	−0.104	0.551	0.341
Patients’ Cognition on Hospitals and Industry (PCHI)	Overall, what was your impression of the current healthcare industry? ((1) Very bad, (2) Fairly bad, (3) General, (4) Fairly good, (5) Very good)	Industry evaluation(Y5)	0.11	−0.041	0.372	0.664
	Overall, what was your evaluation of the current medical and health policy?((1) Very bad, (2) Fairly bad, (3) General, (4) Fairly good, (5) Very good)	Policy evaluation(Y6)	0.051	0.026	0.109	0.768
	Overall, how did you feel the nonprofit nature of Chinese public hospitals? ((1) Very weak, (2) Fairly weak, (3) General, (4) Fairly strong, (5) Very strong)	Commonweal evaluation of public hospitals(Y7)	0.026	−0.009	0.241	0.743
	Overall, how did you feel the reasonability of current medical expenses? ((1) Very unreasonable, (2) Fairly unreasonable, (3) General, (4) Fairly reasonable, (5) Very reasonable)	Reasonability of medical expenses(Y8)	0.015	−0.002	0.243	0.755

Note: Bold values represent factor loading >0.5.

Table 2 Difference of Medical Dissatisfaction Experiences of Patients on Demographic Characteristics

Explanatory Variables		n(%)	Almost Never	Seldom	Generally	Often	Almost Always	Mean Rank	Z	P
Gender	Male	1023(49.5)	534	246	159	69	15	1049.15	−1.338	0.181
	Female	1042(50.5)	566	266	126	72	12	1017.14
Age	≤30	638(30.9)	277	179	116	54	12	1143.85	63.257	0.000
	31 to 40	400(19.4)	197	105	62	33	3	1076.98
	41 to 50	350(16.9)	190	92	42	22	4	1013.16
	51 to 60	307(14.9)	194	61	32	18	2	929.09
	≥60	370(17.9)	242	75	33	14	6	899.29
Marital status	Never married	335(16.2)	156	78	64	30	7	1126.59	16.272	0.001
	Married	1662(80.5)	905	422	207	109	19	1015.30
	Divorced	24(1.2)	10	5	7	1	1	1191.35
	Widowed	44(2.1)	29	7	7	1	0	902.57
Level of education	Primary School or below	307(14.9)	235	48	15	5	4	778.02	147.783	0.000
	Junior high school	542(26.2)	325	113	70	29	5	963.80
	High School/Technical Secondary School/Career College	483(23.4)	255	124	67	33	4	1033.79
	Junior degree	331(16.0)	152	90	50	30	9	1120.90
	Undergraduate or more	402(19.5)	133	137	83	44	5	1247.70

Figure 1 Frequency of medical dissatisfaction experiences.

Figure 2 Reasons for medical dissatisfaction experiences.

Table 3 Standardized Effects Between SR, HEMR, PSC and MDE

Variables	Direct	Indirect	Total
HEMR→MDE	0.250***	0.046***	0.296***
HEMR→PSC	−0.115***	—	−0.115***
PSC→MDE	−0.399***	—	−0.399***
SR→PSC	0.416***	—	0.416***
SR→MDE	—	−0.166***	−0.166***

Note: ***P< 0.001.

Abbreviations: HEMR, health education and media reports; MDE, medical dissatisfaction experiences; PSC, patients’ social cognition; SR, social relationships.

Figure 3 Structural equation modeling of medical dissatisfaction experiences.

Notes: Arrows indicate the associations and directions between variables. All parameter estimates were statistically significant (p<0.001).

Abbreviations: CMIN, Chi-square value; GFI, goodness of fit index; AGFI, adjusted goodness of fit index; RMSEA, root-mean square error of approximation; SR, social relationships; HEMR, health education and media reports; PSC, patients’ social cognition; PCHCWs, patients’ cognition on health care workers; PCHI, patients’ cognition on hospitals and industry; MDE, medical dissatisfaction experiences; FMDE, frequency of medical dissatisfaction experiences.