| Background Health service satisfaction is one of the important indicators to evaluate the quality of health service. Service satisfaction of health institutions at county and township level directly reflects the pros and cons of working in rural health services. About two-thirds of the total population is agricultural population in Yunnan Province which is known as multi-ethnic southwestern border provinces of China. However, research on rural health service satisfaction has been seldomly reported.Objective To understand patient satisfaction in institutions at county and township level, and to explore the influencing factors of satisfaction, to provide a reference for the health authorities developing health policy, so as to meet the basic health service needs of the rural people.Method Stratified cluster sampling method was used in the study. According to the per capita GDP, all counties in Yunnan Province were classified as good, middle and poor groups, and one county was sampled from each group. And then, all townships were sequentially arranged in each country by population in descending. Systematic sampling method was used to choose a sample of three rural townships. All sample included9townships. A questionnaire of "Situational Analysis and Policy Evaluation of Deployment and Retention of Human Resources for Health in Rural West China" was adapted to collect data by interviewing all the out patients met andomly on the whole day in township hospitals and county hospitals, county Chinese traditional medicals and county maternal and child health hospitals.Results (1) The total of582outpatients received survey, including261men,321women. Their average age was36.11±15.611. The patients who only received junior high school education and below accounted for77.8%. Among the subjects,58.6%was farmers,59.8%gained household monthly income below2.000yuan,80.8%had the new rural cooperative medical insurance accounted, and77.2%preferred the institutions at county-level and township level when they suffered from common diseases.(2) Outpatients’overall satisfaction of service in medical institutions at county level was49.0%. Multiple Logistic Regression Analysis indicated that the independent factors which were significantly associated with patients’overall satisfaction were poor service attitude (OR=5.012), unequipmented environment in hospital (OR=1.926), a long time spent on the road from home to health institutions (OR=1.533).(3) Outpatients’overall satisfaction of service in medical institutions at township level was57.6%. Multiple Logistic Regression Analysis showed that t the independent factors which were significantly associated with patients’overall satisfaction were poor service attitude (OR=8.374), insufficient conmunication on therapy between patients and doctors (OR=2.954), expensive diagnosis and treatment cost (OR=2.388), and patients’occupation was farming (OR=1.693).(4) The total of45.0%of the respondents was satisfied with the public health service. The percentage of overall satisfaction of public health services in respondents who only received primary education were higher than that in those with higher education, and farmers were with higher proportion of satisfaction than others. Higher proportion of respondents who had the new rural cooperative medical insurance showed satisfaction to the public health services than those with other insurances. The proportion of respondents who satisfied with each public health service was higher than that of other respondents.Conclusion The overall satisfactions of health services in stitutions at county and township level are low. Patients’overall satisfaction of health services are affected at service attitude, insufficient communication on therapy between patients and doctors, expensive diagnosis and treatment cost, and unequipmented environment in hospital. The overall satisfactory of health services at township level were associated with the time expend and distance from home to health institutions too. This study suggested that it is necessary to strengthen humanistic education and communication skills to health services providers, standardized health services, better the environment of services. It is urgent for government to improve regional health planning, increase health input, and raise health insurance level. |
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