Influential factors on patient satisfaction and effectiveness of health promotion in primary healthcare, Xi'An China

Li, Huan (2024) Influential factors on patient satisfaction and effectiveness of health promotion in primary healthcare, Xi'An China. PhD thesis, UTAR.

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Abstract

Patient satisfaction is an important indicator for evaluating the healthcare system and predicting health outcomes, gaining a deep insight into patient needs, expectations, and experiences is crucial for enhanced healthcare quality. Health promotion can effectively help people change their lifestyle, achieve the best physical, emotional, and other aspects of health, and play an important role in primary healthcare. Xi'an, as a capital city in western China, faces the dual challenges of population growth, diversified medical demand and efficient allocation of medical resources. Especially after the outbreak of COVID-19, Xi'an's primary healthcare institutions have been pushed to the front line of epidemic prevention and control, face the challenges of assessing and managing COVID-19 patients in a larger population setting with limited resources in comparison to hospitals. However, so far, there is still a lack of research on the patient satisfaction with primary healthcare in Xi 'an, and the effectiveness of health promotion intervention on patient satisfaction is still limited. The aim of the study is to determine the patient satisfaction status towards primary healthcare, to determine the factors associated with patient satisfaction, in Xi’an, China, and to determine the effectiveness of the health promotion intervention on patient satisfaction towards primary healthcare in Xi’an City. A cross-sectional study (Phase I) was conducted in primary healthcare institutions in Xi 'an, China. The PSQ-18 questionnaire was used for data evaluation and SPSS version 23.0 for data analysis. A total of 315 patients were recruited. In the multiple linear regression analysis, the highly educated patients had a higher patient satisfaction score than the low-educated patients (β=1.138, 95% confidence interval=0.135–2.141, P=0.026). A single-blind randomized controlled trial design (Phase II) was conducted. The patients were randomly assigned to either an intervention group or a placebo group. Both groups received 3-week Wechat education, with the intervention group receiving online intervention education including nine items, while the placebo group received related information about healthcare and health. Data were collected before and after the intervention, and the results were measured using a social demographic questionnaire and the Patient Satisfaction Questionnaire (PSQ- 18), which were analysed using SPSS 23.0 version. A total of 312 patients were enrolled, with 156 assigned to the intervention group and 156 assigned to the placebo group. The Patient Satisfaction Questionnaire (PSQ-18) revealed that the general satisfaction domain showed the most improvement, increasing from Mean (SD)=3.474 (0.060) to Mean (SD)=3.994 (0.045) before the intervention. Results from the two-way repeated measures ANOVA show to have significant effect on patient satisfaction particularly the general satisfaction, technical quality, communication, financial aspect, and time spent. The patients with a higher educational level showed a higher patient satisfaction level than did those with a lower educational level. The intervention significantly improved patient satisfaction in the intervention group compared to the placebo group, particularly in the areas of general satisfaction, technical quality, communication, and time spent. Keywords: Health promotion intervention; Patient satisfaction; Primary healthcare; Randomized controlled trials

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