This study sought to assess the status of, and factors associated with, knowledge, attitudes, and practices (KAP) related to the establishment of the National Hierarchical Medical System (NHMS) among outpatients receiving care in tertiary hospitals in China.A cross-sectional study surveying tertiary outpatients was conducted. This study investigated KAP concerning the establishment of the NHMS among outpatients from tertiary hospitals, who could have sought medical care from a general practitioner in surrounding primary care medical institutions. Several factors associated with outpatients' knowledge were identified and included in fully adjusted analyses using logistic regression.Survey questionnaires were completed by 565 outpatients in 4 tertiary hospitals. Approximately half (51.86%) of the sample was aware of the NHMS. In multivariable analysis sex, age, education level, and place of residence were associated (P < .05) with knowledge of NHMS. Overall 74.69% of respondents expressed positive attitudes toward the establishment of the NHMS. However, a much lower proportion, 21.95%, was willing to choose nearby grassroots sub-unit hospitals as their first choice when seeking health care.The present study revealed outpatients in China may lack knowledge of the NHMS, yet most have a positive attitude toward the establishment of the NHMS. Even so, there was hesitation in terms of seeking care from the NHMS, indicating the need for policy makers to take action to increase public awareness surrounding NHMS-related information to improve the public's KAP on the establishment of the NHMS. This study highlights information useful for policy makers in China and other countries planning or evaluating related policies.
ObjectiveGeneral practitioners (GPs) are highly underutilised in China with many patients going directly to hospitals when seeking routine care. Multiple countries around the world have successfully used GPs in routine care, and as such, China may benefit from the use of GPs. This study examines the status of, and factors associated with, knowledge related to GPs among outpatient populations from China’s tertiary hospitals.DesignThis is a cross-sectional survey study.Study setting and participantsThe questionnaires were completed by 565 outpatients from four tertiary hospitals in China during 2016. Convenience sampling on different floors and throughout the outpatient building was carried out.Primary outcome measuresWe used the logistic regression models to identify GP-related knowledge among different populations.ResultsOverall, 50.27% of respondents said they had never heard of GPs. This was also true among females (adjusted OR (AOR)=1.57, 95% CI 1.43 to 2.71), older adults (AOR46–65=1.61, 95% CI 1.39 to 2.98; AOR>65=2.01, 95% CI 1.62 to 3.59), those with lower education level (AORBachelor’s degree=0.61, 95% CI 0.20 to 0.81; AOR≥Master’s degree=0.49, 95% CI 0.23 to 0.76), rural residents (AOR=1.51, 95% CI 1.35 to 2.82) and those with chronic disease (AORwithout chronic disease=0.61, 95% CI 0.22 to 0.71). What is more, less than one-in-ten (9.03%) outpatients were able to accurately describe what a GP was, with less than 30% accurately describing a GP among those receiving GPs’ services.ConclusionsOutpatients who could have received less costly health services from GPs in primary medical institutions were more likely to choose costlier specialist physicians in tertiary hospitals, which is likely linked to limited knowledge about GPs. Policy makers should invest in outreach efforts to improve public awareness of GPs, while at the same time conducting continued surveillance of these efforts to evaluate progress towards this goal.
PurposeThis study aimed to determine the factors that influence patient satisfaction with ecdemic medical care.Materials and methodsEight hundred and forty-four face-to-face interviews were conducted between October and November 2017 in two high-profile hospitals in Nanchang, China. Patient satisfaction was divided into lowest and highest satisfaction groups according the 80/20 rule. Demographic factors associated with patient satisfaction were identified by logistic regression models.ResultsRespondents’ main reasons for choosing a non-local hospital were “high level of medical treatment” (581/844), “good reputation of the hospital” (533/844), and “advanced medical equipment” (417/844). The top three items that dissatisfied the ecdemic patients were “long time to wait for treatment” (553/844), “complicated formalities” (307/844), and “poor overall service attitude” (288/844). Fewer female patients (adjusted odds ratio [AOR] =1.47, 95% confidence interval [CI] =1.03–2.11), patients with a family per-capita monthly income (FPMI) between 3,001 and 5,000 CNY (AOR =1.40, 95% CI =1.01–2.17), inpatients (AOR =1.46, 95% CI =1.01–2.13), and more patients with an FPMI >7,000 CNY (AOR =0.43, 95% CI =0.20–0.92) were detected in the lowest satisfaction group. Fewer patients with an associate’s or bachelor’s degree (AOR =2.40, 95% CI =1.37–4.20) and patients with an FPMI >7,000 CNY (AOR =3.02, 95% CI =1.10–8.33) were detected in the highest satisfaction group. Moreover, more inpatients (AOR =0.70, 95% CI =0.54–0.97) and those aged 46–65 years (AOR =0.63, 95% CI =0.33–0.98) were detected in the highest satisfaction group.ConclusionFindings suggested that managers of the medical facilities should note the importance of increasing their publicity through a rapidly developing media, as well as the necessity of creating a more patient-friendly medical care experience. Hospitals should also focus on the medical care experience of patients with relatively lower and higher income levels, male ecdemic patients, and ecdemic outpatients.
Prison medical workers (PMWs) are critically important, but they are also vulnerable to psychological problems. Currently, there is no study on examining PMWs’ mental health conditions and possible influencing factors in China. Hence, we conducted this cross-sectional survey, aiming to understand the mental health status of the PMWs and related impact factors in Jiangxi province of China. We employed the Chinese version of the Symptom Checklist-90-R (SCL-90-R) to assess the mental disorders and psychological health conditions of PMWs in Jiangxi. The t tests were used to compare the differences for the average score of SCL-90-R between the Chinese general population and targeted PMWs of this study. Multivariable logistic regression analyses were conducted to identify the main factors associated with overall detection rate of PMWs’ psychological health conditions. The scores of four dimensions (somatization, obsessive-compulsive symptoms, anxiety, and paranoid ideation) were significantly higher than the Chinese national norm, and the total positive rate was 49.09% among the PMWs. Gender, marital status, age, and length of employment are identified to be the most significant predictors to affect PMWs’ mental health. Positive correlations between each of the nine dimensions of the SCL-90-R have been verified. This study demonstrated for the first time that PMWs are facing mental health risk and suffering serious psychological problems with psychopathology symptoms, which has become a growing concern in China. Our current findings suggest a need for more in-depth studies on this subject going forward to validate our conclusions and also to identify more impact factors, since such studies and knowledge of PMWs’ mental health and influencing factors are very limited in China.
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