ArticleBMC health services research2026
Patient satisfaction with cross-boundary healthcare: a cross-sectional study of Hong Kong residents' healthcare utilization in mainland China.
Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatient satisfaction is a proxy indicator for evaluating the efficiency, equity and quality of healthcare provision. Recent years have seen increasing cross-boundary healthcare utilization worldwide along with enhanced population mobility amidst the globalization process, while empirical research on patients’ satisfaction with cross-boundary healthcare services is limited. This study aims to enrich the understanding of patient satisfaction with cross-boundary healthcare utilization, and provide policy implications for healthcare governance.
methodsA cross-sectional study was conducted in 2023. A total of 3500 Hong Kong residents were sampled in Hong Kong, Guangzhou, and Shenzhen proportional to the age structure, among which 1208 had cross-boundary healthcare experiences in mainland China. The PSQ-18 (Patient Satisfaction Questionnaire-18), a standard validated questionnaire with seven subscales was used to measure patient satisfaction. Satisfaction/dissatisfaction with cross-boundary healthcare was differentiated according to whether a patient’s PSQ-18 score for mainland China’s healthcare services was higher or no higher than that for Hong Kong’s healthcare services. Binary logistic regression models were run to explore the associations between satisfaction/dissatisfaction and patients’ socio-demographic characteristics.
resultsAmong respondents, 19.3% expressed higher “general satisfaction” with healthcare services in mainland China than that in Hong Kong. The “interpersonal manner” of cross-boundary healthcare received the highest rating (83%) while “financial aspects” scored the lowest (67%). Mainland China’s healthcare facilities performed better in “interpersonal manner” and “accessibility and convenience” compared to Hong Kong, but improvements were needed in other subscales. Patients’ socio-demographic characteristics such as age (AOR: 2.62, 95% CI: 1.66–4.13), gender (AOR: 0.71, 95% CI: 0.52–0.98), children (AOR: 1.76, 95% CI: 1.10–2.81), employment (AOR: 0.52, 95% CI: 0.34–0.80), or duration of stay in mainland China (AOR: 0.62, 95% CI: 0.42–0.91) were associated with general satisfaction with cross-boundary healthcare. Household income, mainland China’s media use frequency, and health status significantly influenced multiple dimensions of patient satisfaction (p < 0.05). Age emerged as the strongest predictor across all seven PSQ-18 dimensions.
conclusionThe level of patient satisfaction with cross-boundary healthcare and its influencing factors varies across different dimensions. Targeted interventions to promote cross-boundary healthcare utilization among Hong Kong residents should prioritize the elderly, males, employees, patients with dependent child(ren), and low-income groups.
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