ABSTRACT
OBJECTIVE@#To understand the relationship between health literacy and patient experience of outpatients in China, and to explore its mechanism.@*METHODS@#The conceptual framework was developed based on Andersen's behavioral model of health services use and health literacy skills framework. An online cross-sectional survey was conducted with snowball sampling method, while the health literacy was measured by self-designed patient health literacy scale, and the patient experience was measured by the Chinese patient experience questionnaire for ambulatory care developed by Peking Union Medical College. And a structural equation model was built to explore the relationship between them and test the mechanism of health literacy influencing patient experience.@*RESULTS@#A total of 2 773 subjects were investigated. The average score of health literacy was (90.72±12.90) points, accounting for 78.89% of the full score, and the dimension of seeking social support had the lowest score. The average score of overall rating of patient experience was (3.71±0.74) points, and the scores of each dimension of patient experience were between 3.56 and 3.80. The model fit indices of structural equation model for overall rating of patient experience among the outpatients were χ2/df=9.29 (χ2=4 107.27, df=442), root mean square error of approximation (RMSEA)=0.055 (< 0.06), comparative fit index (CFI)=0.926 (>0.90), Tucker-Lewis index (TLI)=0.918 (>0.90), standardized root mean square residual (SRMR)=0.061 (< 0.08), the model was acceptable. The variance in patient experience explained by the model was 0.108. The structural equation model analysis results showed that the overall rating of outpatient experience was directly affected by health literacy (β=0.263, P < 0.001), also indirectly affected by health literacy (β=0.012, P < 0.001). In other words, the overall rating increased by 0.275 units for each standard deviation increase of health literacy. Self-evaluated health status mediated the relationship between health literacy and the overall rating of outpatient experience. In terms of diffe-rent dimensions of patient experience, the standardized path coefficient of the total effect of health literacy on patient experience was as follows: Information guidance 0.337, humanistic care 0.319, communication with doctors 0.294, service efficiency 0.240, and hospital environment 0.173.@*CONCLUSION@#The patients with higher level of health literacy were more likely to have a better outpatient experience in China, and the information guidance experience and humanistic care experience were most affected by health literacy. And the communication and information utilization ability had the greatest influence on patient experience.
Subject(s)
Humans , China , Cross-Sectional Studies , Health Literacy , Outpatients , Patient Outcome Assessment , Surveys and QuestionnairesABSTRACT
Objective:In this study,through the description of understanding,behavior,evaluation about med-ical alliances,we explore the problems and made recommendations to medical alliances. Methods: A questionnaire survey was conducted on 556 medical staff in 18 medical alliances in Beijing. We used descriptive statistical methods to analyze the situation of cognition and so on. And we compared medical staff evaluation of medical alliances be-tween core hospital and cooperative hospital. Results: Only 5.40 % of medical staff are totally unaware of the medical alliances policy. 38.73 % of the doctors don't conduct two-way referral. 55.69 % of the doctors in the core hospital don't come to the cooperative hospital. 71.40 % of the medical staff think that the operation of the medical alliances is good. There are big differences in the distribution of overall evaluation between core hospital medical staff and cooperative hospital medical staff by rank sum test. Conclusion: The understanding of medical alliances and the evaluation of activities are better. However, the two-way referral effect is not obvious and some specific activities are not ideal.
ABSTRACT
Objective:This article analyzes the cognition and satisfaction evaluation of patients in medical alli-ance. Under the medical alliance mode,the present study tries to explore the choice of medical treatment of patients, the first diagnosis of primary health care institutions and its influencing factors, in order to provide reference for the construction of medical alliance. Methods:With the help of stratified sampling method,eighteen (18) medical alli-ances were selected from 16 districts and counties in Beijing. The survey questionnaire was designed to be used as the tool for data collection. A total of 1 280 patients in medical alliance participated in this study. The Chi-square Test and binary logistic regression model were used for statistical analysis. Results:59.12% of patients understand the medical association and related policies. 39.12% of the patients are satisfied with the medical association,51.44% of patients are willing to take first diagnosis at primary health care institutions. The distribution of medical resources in various districts is uneven. The type of hospital visited,the degree of understanding of medical alliance,the expe-rience of medical alliance and the satisfaction toward medical alliance will have an impact on the willingness about basic initial diagnosis,and the influence make a significant statistical sense. Conclusions:The Medical alliance con-struction in Beijing has achieved a certain effect,as first visit at primary health care institutions will be the initial for-mation. But the unbalanced distribution of medical resources in various districts,the service capacity of primary care institutions which does not meet the needs of patients,the insufficient sensitization of relevant policy and the current health insurance policy are seen as limiting factors to the development of medical alliance.