Key nodes affecting patient satisfaction in a cross-regional referral service process: an empirical analysis study in Sichuan

Abstract

BackgroundThe referral service is a significant component of healthcare reform in China, and the measurement of patient satisfaction with the referral service process will help to improve the quality of referral medical delivery. Furthermore, the referral service in China includes inter-institutional collaborations between hospitals at different levels and multi-nodes throughout the referral process. It is therefore necessary to identify the key nodes that affect patient satisfaction during the referral service process.MethodsThis study conducted a questionnaire survey of 110 patients to collect data regarding patient satisfaction at the following healthcare nodes: primary-level hospital, referral appointment registration, claim of appointment number in the outpatient department, examination service, admission service, and overall satisfaction during the referral service process. Correlation analysis and logistic regression methods were used to establish a mathematical model of patient satisfaction between five nodes and overall satisfaction. Additionally, a peak-end model was formed to identify the peak node impacting overall patient satisfaction during the referral service based on the sample data.ResultsOver 80% of referral patients rated the overall referral service as ‘good’. The correlation analysis revealed that there was a significant correlation between the satisfaction of each node and the overall satisfaction (P < 0.05). The results of the regression model showed that the satisfaction of five nodes determined the overall satisfaction and that “admission service at the higher-level hospital” exerted the greatest impact on overall satisfaction (β = 0.312), while “referral appointment registration” had the lowest influence on overall satisfaction (β = 0.177). The peak-end model also revealed that “admission service at the higher-level hospital” had a greater effect on overall satisfaction.ConclusionOur study showed that the key nodes affecting patient satisfaction were “transferring service at the primary-level hospital” and “admission service at the higher-level hospital”. Furthermore, the efficacy of the referral services is determined by the gatekeepers’ management of the referral system at the primary-level hospital and the allocation and management of bed resources at the higher-level hospital. These findings can serve as a science-based guidance for them to improve their performance in inter-regional healthcare collaborations in the referral service process.

Effects of a comprehensive reservation service for non-emergency registration on appointment registration rate, patient waiting time, patient satisfaction and outpatient volume in a tertiary hospital in China

“…The role of tertiary hospitals was thus played, and the grading diagnosis and treatment were also observed. Referral service is an important part of medical reform in China [26]. Continuous attention should be paid to the reservation and referral tracking [27].…”

Evaluation of patient satisfaction in hospitals in China 2003–2013: A national longitudinal analysis of population-based survey data

“…Previous studies also found a significant relationship between the hospital referral mechanism and patient satisfaction [33]. A rational referral mechanism is the basis for scientifically controlling and optimizing the allocation of medical resources and the mobility of patients.…”

“…With the development of the economy, the quality of hardware devices, such as medical equipment, can be directly and easily improved in a short period of time. By contrast, how to enhance the medical ability and professional quality of physicians, especially of those in primary hospitals [32,33], and how to optimize the allocation of medical resources from a national perspective remain great challenges for the government. These problems can be viewed as the main cause of the phenomena of "difficulty and high cost of getting medical service" in China to date, and they are continuously cited as the primary solution targets by healthcare policies [34].…”

A Combined Behavioural Economics- and Simulation-based Medical Education to Promote Effectiveness among Medical Residents in Coping with Workplace Violence in Northern China: A Quasi-Experimental Study

“…The SBME + BE group received 3 hours' training on 'behavioural economics of workplace violence education' and 'simulation education on workplace violence'. Behavioural economics studies have shown that peak-end rule [52], loss aversion [53], and framing effects [54] have a direct impact on patient satisfaction, medical decision-making, and doctor-patient communication, which are closely related to the occurrence of workplace violence [55,56] (see Fig. 2).…”