Public satisfaction with health system after healthcare reform in China.

BACKGROUND: The Chinese central government launched the third phase of health system reforms in 2009. After a decade since the initiation of the reform, the health system has witnessed noteworthy gains. However, there is no concurrent improvement in public satisfaction with the health system. This study analysed various factors that influence public satisfaction with the system and examined whether perceived quality of care affects public satisfaction. METHODS: A longitudinal nationally representative survey was used for this study. We used five waves of China Family Panel Studies (CFPS) survey data. The final sample consisted of 145 843 observations. A two-way fixed-effects ordered logistic model was used for the analysis. RESULTS: The results indicate that perceived good quality of care was positively associated with public satisfaction in health system regardless of rural-urban residence. Older adults and individuals with more than 3 years of college education were less likely to be satisfied with the system in rural areas. Personal income and the density of medical professionals in the geographic area tend to improve public satisfaction in rural areas. Having medical insurance coverage and fair or good self-rated health improved the probability of reporting public satisfaction in urban areas. Married people and individuals who lived in the West region were less likely to be satisfied with the health system in urban areas. CONCLUSIONS: Knowledge and skills of healthcare providers or physical quality of facilities are not sufficient in improving public satisfaction in the health system. Policymakers need to identify options to influence the important factors that affect public perception of the system. This analysis identified several policy-amenable factors to improve public perception of the health system in rural and urban China.

Association between personality traits and smoking cessation among Chinese adults.

BACKGROUND: Although the tobacco epidemic is one of the greatest public health threats, the smoking cessation rate among Chinese adults is considerably lower. Personality information may indicate which treatments or interventions are more likely to be effective. China is the largest producer and consumer of tobacco worldwide. However, little is known about the association between smoking cessation and personality traits in China. AIM: This study aimed to examine the association between successful smoking cessation and personality traits among Chinese adults. METHODS: This cross-sectional study used data from the 2018 China Family Panel Studies. Probit regression models were employed to analyze the association between successful smoking cessation and personality traits stratified by sex. RESULTS: Lower scores for neuroticism (Coef.=-0.055, p < 0.1), lower scores for extraversion (Coef.=-0.077, p < 0.05), and higher scores for openness to experience (Coef.=0.045, p < 0.1) predicted being a successful male quitter after adjusting for demographics. Moreover, lower scores for conscientiousness (Coef.=-0.150, p < 0.1) predicted being a successful female quitter after adjusting for demographics. CONCLUSION: The empirical findings suggested that among Chinese men, lower levels of neuroticism, lower levels of extraversion, and higher levels of openness to experience were associated with a higher likelihood of smoking cessation. Moreover, lower levels of conscientiousness were associated with successful smoking cessation among Chinese women. These results showed that personality information should be included in smoking cessation interventions.

Empathy in Chinese medical students: psychometric characteristics and differences by gender and year of medical education.

BACKGROUND: In recent years in China, the tense physician-patient relationship has been an outstanding problem. Empathy is one of the fundamental factors enhancing the therapeutic effects of physician-patient relationships and is significantly associated with clinical and academic performance among students. METHODS: This cross-sectional study used the JSPE-S (The Student Version of the Jefferson Scale of Physician Empathy) to assess 902 medical students from 1st year to 4th year at China Medical University. The reliability of the questionnaire was assessed by Cronbach's alpha coefficient. We performed an exploratory factor analysis to evaluate the construct validity of the JSPE-S. Group comparisons of empathy scores were conducted via the t-test and one-way ANOVA. Statistic analysis was performed by SPSS 13.0. RESULTS: The Cronbach's alpha coefficient was 0.83. The three factors emerging in the factor analysis of the JSPE-S are "perspective taking", "compassionate care" and "ability to stand in patients' shoes", which accounted for 48.00%. The mean empathy score was 109.60. The empathy score of medical students had significant differences between different genders (p < 0.05) and academic year level (p < 0.05). CONCLUSIONS: This study provided support for the validity and reliability of the Chinese translated version of the JSPE-S for medical students. Early exposure to clinical training and a curriculum for professional competencies help to enhance the empathy of medical students. We suggest that the curriculum within Chinese medical schools include more teaching on empathy and communicational skills.