For information about COVID-19, including symptoms and prevention, please read our COVID-19 patient guide. Please also consider supporting Weill Cornell Medicine’s efforts against the pandemic.

Patient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding.

TitlePatient experience with outpatient encounters at public hospitals in Shanghai: Examining different aspects of physician services and implications of overcrowding.
Publication TypeJournal Article
Year of Publication2017
AuthorsBao Y, Fan G, Zou D, Wang T, Xue D
JournalPLoS One
Volume12
Issue2
Paginatione0171684
Date Published2017
ISSN1932-6203
KeywordsAmbulatory Care, China, Community Health Centers, Crowding, Decision Making, Health Services Accessibility, Hospitals, Public, Humans, Outpatients, Physician-Patient Relations, Quality of Health Care, Retrospective Studies
Abstract

BACKGROUND: Over 90% of outpatient care in China was delivered at public hospitals, making outpatient experience in this setting an important aspect of quality of care.

OBJECTIVE: To assess outpatient experience with different aspects of physician services at China's public hospitals and its association with overcrowding of the hospital outpatient departments.

RESEARCH DESIGN: Retrospective analysis of a large survey of outpatient experience in Shanghai, China. We tested the hypotheses that patient experience was poorer with physician-patient communication, education, and shared decision-making and where and when there was greater overcrowding of the hospital outpatient departments. Ordered logistic models were estimated separately for general and specialty hospitals.

SUBJECTS: 7,147 outpatients at 40 public hospitals in Shanghai, China, in 2014.

MEASURES: Patient experience with physician services were self-reported based on 12 questions as part of a validated instrument. Indicators of overcrowding included time of visit (morning vs. afternoon, Monday vs. rest of the week) and hospital outpatient volume in the first half of 2014.

RESULTS: Overall, patients reported very favorable experience with physician services. Two out of the 12 questions pertaining to both communication and shared decision-making consistently received lower ratings. Hospitals whose outpatient volumes were in the top two quartiles received lower patient ratings, but the relationship achieved statistical significance among specialty hospitals only.

CONCLUSIONS: Inadequate physician-patient communication and shared decision-making and hospital overcrowding compromise outpatient experience with physician services at Chinese public hospitals. Effective diversion of patients with chronic and less complex conditions to community health centers will be critical to alleviate the extreme workloads at hospitals with high patient volumes and, in turn, improve patient experience.

DOI10.1371/journal.pone.0171684
Alternate JournalPLoS ONE
PubMed ID28207783
PubMed Central IDPMC5312958
Category: 
Faculty Publication