General and Vulnerable Population’s Satisfaction With the Healthcare System in Urban and Rural Areas: Findings From the European Social Survey

Care service supply's impact on household consumption inequality in the context of "one old and one young" families

Introduction

With aging and family nuclearization, providing care for older adults and children has become a global issue. This study empirically examines the impact of care service supply on household consumption inequality.

Methods

Data from the China Family Panel Studies are analyzed using the ordinary least squares estimation method.

Results

First, childcare and older adult care significantly impact household consumption inequality by 0.23 and 0.35%, respectively. Further, their impacts on household consumption inequalities at different inequality levels show gradually increasing trend. Moreover, significant group heterogeneity is observed in the impact coefficients. Second, under the dual care pressures for childcare and older adult care, the supply of dual-care services significantly affects household consumption inequality by 0.05%.

Conclusion

Care service supply has an income effect; that is, the supply of family care services affects household consumption inequality by influencing household income inequality. Policy considerations include improving the precision of social welfare and assistance policies, and enhancing the supply mechanism of care services.

User satisfaction with health services and healthcare delivery in Cape Verde

BACKGROUND

The evaluation of health services and care is an important tool to define health policies. This study aimed at assessing user satisfaction with healthcare services, provided by public and private health facilities in Cape Verde. It was also our objective to analyze the sensitivity of satisfaction scores in relation to the respondent's sex.

METHODS

A cross-sectional, with a quantitative approach, was conducted. The study included individuals aged over 18 years. Participants were visiting a health facility at the time of the interview. All subjects signed an informed consent. Data were collected using a standardized self-administered questionnaire. Descriptive and inferential statistical analyses were performed using SPSS software, version 29.

RESULTS

A total of 3,445 subjects took part in the study, 72% were women. The 25-45 age group accounted for 55.1% of the participants, 71.1% of whom declared themselves single. In general terms, women always gave higher satisfaction values. Specifically, in relation to age, those between 25 and 35 years old, single and with secondary education were more satisfied with professionals, access and social action and support, especially in private care. Those who were 45 years old or older better evaluate the care process. Previous consultation experience had a positive effect on women's satisfaction with professionals, facilities, access, social action and support and care process. On the contrary, the same areas of analysis, in hospitalization, were better evaluated by women without any previous experience. On the other hand, married or living together men were more satisfied with facilities and administrative services, and these services, as well as access, were better evaluated by those with less education. Men were also the most satisfied with the accessibility and costs on health centers, as well as hospital facilities. With regard to facilities and accessibility, the highest levels of satisfaction were found on the islands of Fogo and São Vicente. The highest level of dissatisfaction was found on the island of São Nicolau (facilities, access and social action and support), followed by the island of Sal (professionals and care process) and the island of Fogo (accessibility and administrative services).

CONCLUSIONS

Our study suggests that the quality of healthcare services can be significantly improved, especially regarding access and accessibility to healthcare, drug policy and recruitment of qualified professionals.

Public satisfaction with health system after healthcare reform in China

BACKGROUND

The Chinese central government launched the third phase of health system reforms in 2009. After a decade since the initiation of the reform, the health system has witnessed noteworthy gains. However, there is no concurrent improvement in public satisfaction with the health system. This study analysed various factors that influence public satisfaction with the system and examined whether perceived quality of care affects public satisfaction.

METHODS

A longitudinal nationally representative survey was used for this study. We used five waves of China Family Panel Studies (CFPS) survey data. The final sample consisted of 145 843 observations. A two-way fixed-effects ordered logistic model was used for the analysis.

RESULTS

The results indicate that perceived good quality of care was positively associated with public satisfaction in health system regardless of rural-urban residence. Older adults and individuals with more than 3 years of college education were less likely to be satisfied with the system in rural areas. Personal income and the density of medical professionals in the geographic area tend to improve public satisfaction in rural areas. Having medical insurance coverage and fair or good self-rated health improved the probability of reporting public satisfaction in urban areas. Married people and individuals who lived in the West region were less likely to be satisfied with the health system in urban areas.

CONCLUSIONS

Knowledge and skills of healthcare providers or physical quality of facilities are not sufficient in improving public satisfaction in the health system. Policymakers need to identify options to influence the important factors that affect public perception of the system. This analysis identified several policy-amenable factors to improve public perception of the health system in rural and urban China.

Socioeconomic inequality in public satisfaction with the healthcare system in China: a quantile regression analysis

Background

As China pursues better social equality and improvement in public services (healthcare), public satisfaction has been considered as a key performance indicator. There is a great need to better understand the disparities and inequalities in the public satisfaction with its healthcare system.

Methods

Based on Chinese General Social Survey (CGSS) 2015 ( a set of nationally representative survey data, the most recent wave containing information about public satisfaction with the healthcare system), this study utilizes the quantile regression method to analyze how the public satisfaction at high or low quantile of the score distribution varies according to the socio-economic status and healthcare system performance indicators, especially in rural areas.

Results

This study found that, at the highest percentile, better Self-Reported-Health (SRH) is associated significantly with a lower satisfaction score (coefficient -4.10, P < 0.01). High socioeconomic status (especially "above average" group) has higher satisfaction scores at both mean (coefficient 3.74, P<0.01) and median (coefficient 3.83, P<0.01). This effect is also significant across the lower quantiles of the satisfaction levels. West and Middle region (the less developed regions) tended to be more satisfied, whereas those in Northeast reported a large negative effect (coefficient -7.07, P < 0.01) at the median. While rural residents generally reported higher levels of satisfaction, rural residents’ preference regarding hospital beds and primary care access seems generally to be opposite to that of urban residents.

Conclusion

Our findings suggest that the ongoing healthcare reform needs to integrate more preventive care to meet the healthy residents’ expectation and demands. More attention should be guided to the vulnerable healthcare system in the Northeast region, which has a stagnant local economy. Outcome-based quality care is especially preferred in rural healthcare, in addition to improvement of utilization and access. In addition, the “pro-rich” inequality is an ongoing concern about the system.