Predictors of patient satisfaction and outpatient health services in China: evidence from the WHO SAGE survey.

backgroundPatient satisfaction is an essential indicator in medical practise and research. To monitor the health and well-being of adult populations and the ageing process, the World Health Organization (WHO) has initiated the Study on Global AGEing and Adult Health (SAGE), compiling longitudinal information in six countries including China as one major data source.

objectiveThe objective of this study was to identify potential predictors for patient satisfaction based on the 2007-10 WHO SAGE China survey.

methodsData were analysed using random forests (RFs) and ordinal logistic regression models based on 5774 responses to predict overall patient satisfaction on their most recent outpatient health services visit over the last 12 months. Potential predictor variables included access to care, costs of care, quality of care, socio-demographic and health care characteristics and health service features. Increase of the mean-squared error (incMSE) due to variable removal was used to assess relative importance of the model variables for accurately predicting patient satisfaction.

resultsThe survey data suggest low frequency of dissatisfaction with outpatient services in China (1.8%). Self-reported treatment outcome of the respective visit of a care facility demonstrated to be the strongest predictor for patient satisfaction (incMSE +15%), followed by patient-rated communication (incMSE +2.0%), and then income, waiting time, residency and patient age. Individual patient satisfaction in the survey population was predicted with 74% accuracy using either logistic regression or RF.

conclusionsPatients' perceived outcomes of health care visits and patient communication with health care professionals are the most important variables associated with patient satisfaction in outpatient health services settings in China.