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This paper explores accountability on medical service quality in China. Based on a literature analy-sis and model building, the paper analyzes different actors involved in the management of medical service quality in China from the‘who is accountable, accountable to whom, accountable for what’ three dimensions. The study found that there is a gap between how managers and patients perceive quality, and we need to start the patients’ accountabil-ity. Appeared quality standard gap and service delivery gap, we need to start the medical institutions internal ac-countability. Appeared marketing communication gap, we need to start the social accountability. Among the entire accountability system, how to improve patient satisfaction and the quality of medical services, patients’ accountability plays a key role, is the core part of the accountability system.
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Objective: To study the determinants that affect patient satisfaction to rural doctors. Methods:Based on survey data of Liupanshui City, Guizhou Province, structural equation modeling analysis was adopted, and the study was mainly from the following four aspects:the image of rural doctors, service quality, quality of diagnosis and treatment, and harmonious doctor-patient relationships. Results: The study found that the quality of diagnosis and treatment had the greatest direct impact on rural patient satisfaction, followed by service quality, the image of ru-ral doctors and harmonious doctor-patient relationships;rural patient satisfaction has a significant impact on rural pa-tient loyalty. Conclusion:Rural patient satisfaction and loyalty to rural doctors is mainly based on kinship and geopo-litical relations;given the state of medical technology, the medical environment, medical equipment, service aware-ness and other restrictions, rural doctors cannot fulfill the “gatekeeper” role, and consequently, the primary health-care system has been severely affected.