Patterns of Outpatient Service Satisfaction among Low-Income Adults in Rural China: A Latent Class Analysis.

(1) Background: Low-income rural residents in China are disadvantaged due to their financial vulnerability and insufficient access to resources, and this situation demands more research effort. This study examined the pattern of outpatient service satisfaction and its determinants among low-income adults in rural China. (2) Methods: Rural low-income respondents who used outpatient services in their local healthcare facilities in Jiangsu, China evaluated the access, cost, environment, doctor-patient interaction, and other topics during their outpatient visit (N = 662). Latent class analysis was used to identify the groups characterized by various dimensions of outpatient satisfaction. Multinomial logistic regression explored the determinants of class membership. (3) Results: Three latent classes were identified: 28.70% had low satisfaction, unsatisfied with every dimension; 20.69% reported medium satisfaction that valued doctor-patient relationships; and 50.60% had high satisfaction but thought that costs were high. Both low and medium satisfaction were associated with a higher proportion of self-paid fees. (4) Conclusions: Healthcare costs were an important determinant of outpatient service satisfaction. Medical social workers are suggested to be included in the medical team to help patients identify financial assistance. Special aid programs may be developed to help relieve rural low-income patients' medical cost-related burden.

From Bureaucratic Coordination to a Data-Driven Model: Transformation and Capacity Building of Community-Based Prevention and Control of Public Health Events.

Communities are the first line of defense in responding to major public health events. Taking the community-based prevention and control cases of COVID-19 in China as samples, this paper constructs an analytical framework for the generation of community-based prevention and control capacity of public health events from the perspective of governance elements optimization based on the methods of text analysis and limits-to-growth archetype analysis. According to the research, the community-based prevention and control of public health events realizes the integration of governance elements of key actors through the bureaucratic coordination mode and maximizes the prevention and control efficiency with the primary goal of epidemic prevention and control in a short period of time, which presents a "reinforcing feedback" loop in the "limits-to-growth" model system. However, with the development of the epidemic showing a strong trend of being latent and wide spread, the "reinforcing feedback" from the bureaucratic coordination model on the effect of epidemic prevention and control encounters the "regulatory feedback" that inhibits the growth at the data-driven level. On the basis of discussing the practice of the public health prevention and control mode in the grassroots communities under the established political framework, this paper attempts to construct an institutional reform system from technological governance to technological empowerment, so as to effectively realize the mode transformation of community-based prevention and control of public health events.