Patient Experiences of Hospital Care in South Korea in Three Biennial National Surveys from 2017 to 2021 Running Title: Patient Experiences in Korea

Patient Experiences of Hospital Care in South Korea in Three Biennial National Surveys from 2017 to 2021 Running Title: Patient Experiences in Korea | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Patient Experiences of Hospital Care in South Korea in Three Biennial National Surveys from 2017 to 2021 Running Title: Patient Experiences in Korea Yangjoong Kim, Young-Ae Jeong, Dong-Sook Kim This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7106896/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Objective To evaluate hospital care quality from patients' perspectives and identify individual and institutional factors influencing patients’ experiences, with policy implications for hospital workforce planning in South Korea. Study Design: Cross-sectional study Methods We analyzed data from the Korean National Patient Experience Survey (KNPES) administered in 2017, 2019, and 2021, targeting patients aged ≥ 20 years discharged from 601 hospitals. The 24-item survey assessed five domains: physicians, nurses, treatment process, hospital environment, and patient rights. Composite scores were computed. Multiple regression analysis identified demographic and institutional predictors. Results Responses were obtained from 14,970 (2017), 23,924 (2019), and 58,258 (2021) patients (mean age: 56.3 ± 15.3 years; 50.2% male). The overall composite score was 83.94 ± 15.98. Nurse communication consistently received the highest ratings, while patient rights received the lowest. Factors significantly associated with higher patient experience scores included younger age, higher education, Medical Aid enrollment, treatment in internal medicine, secondary hospital status, and higher nurse staffing levels. Conclusions Nurse staffing levels exhibited the strongest association with positive patient experiences. These findings underscore the importance of nurse workforce policies in improving care quality and patient-centered outcomes. patient experience hospital care national survey health policy South Korea Figures Figure 1 Introduction The rapid aging of the population is driving a sharp rise in multimorbidity. Empowering individuals through tailored information and shared decision-making has proved effective in chronic diseases. 1 Patient experience and healthcare quality are key measures for improving clinical outcomes. 2 Treating patients as partners in their healthcare 3 has elevated the importance of interactions between healthcare professionals and patients for both treatment outcomes and patient well-being. 4 – 6 Avedis Donabedian, a prominent figure in this field, identified three components of healthcare quality: technical quality, which refers to the effectiveness of care in achieving possible health improvements; interpersonal quality, which involves accommodating patient needs and preferences; and amenities, which include physical surroundings and organizational attributes. However, contemporary quality initiatives still privilege technical metrics, often overlooking the interpersonal and environmental domains that matter most to patients. 7 Interactions between healthcare providers and patients are sometimes underestimated, and assessments of those interactions often fail to address the complexities involved in quality of care. This can blunt the impact of even substantial resource investment in structural and procedural aspects. A systematic review linked superior patient experience to better clinical outcomes. 1 This evidence has intensified interest in how the patient experience relates to quality of care. As early as 1977, the World Health Organization (WHO) advocated for patient participation in their own healthcare. 2 , 3 The ensuing movements toward patient-centeredness and empowerment have expanded patient autonomy in clinical decisions. 2 , 5 , 6 Over the past decade, many health systems have embedded patient-reported experience measures (PREMs) into quality-improvement programs, using them to steer reforms that prioritise patient satisfaction and overall care quality. 4 After achieving universal health insurance coverage through the National Health Insurance (NHI) program in 1989 8 , South Korea tasked the Health Insurance Review & Assessment Service (HIRA) in South Korea with reviewing patient experiences to enhance healthcare quality. In 2017, HIRA launched a nationwide PREM-based patient experience survey as part of its healthcare quality assessment program. The Korean government adopted the classic framework on quality of care developed by Donabedian 9 and the Institute of Medicine in the United States, initiating the QA program in 2001. This program encompasses 36 areas and is implemented across a spectrum of conditions, including acute diseases like stroke and pneumonia, chronic diseases such as hypertension, diabetes, chronic obstructive pulmonary disease, asthma, and cancer, as well as antibiotic use for respiratory diseases and long-term care within Korea. 10 The outcomes of PREMs have been researched in the USA, Canada, England, and China. 11 – 16 In Korea, despite three government-conducted patient experience evaluations, no study has yet provided a comprehensive analysis of the nationwide patient experience survey. Additionally, there has been limited research into the patient and hospital-level factors that influence patient experience. This study explored the current state of patients’ experiences with healthcare and sought to identify areas for improvement by analyzing survey data from South Korea. We also examined patient- and hospital-level factors that influence the patient experience. Methods Data and study population This cross-sectional study involved administering a representative survey to discharged patients aged 20 years and older in hospitals, utilizing the Korean National Patient Experience Survey (KNPES) across three years: 2017, 2019, and 2021. Inpatients from the Departments of Pediatrics and Psychiatry were excluded from the study. The selection criteria for target hospitals varied: in 2017, hospitals with 500 or more beds were included; in 2019, the criteria were adjusted to include hospitals with 300 or more beds; and in 2021, the study focused on tertiary general hospitals and general hospitals with at least 100 beds. The target patients had been hospitalized for more than one overnight stay in tertiary and secondary hospitals and were discharged within a period ranging from 2 days to 8 weeks. Telephone surveys were conducted in three separate periods: between July and October 2017, May and November 2019, and May and November 2020. Each patient's phone number was obtained upon request from the respective hospital. The discharged patients were categorized based on the type of hospital and the number of beds available, with survey data collected from 150 to 250 patients per hospital. Survey Instrument The KNPES consists of 24 items (Supplementary material). Nineteen items across 5 domains measure aspects of the hospital experience, and there are two overall hospital assessment items and three individual items to adjust for the mix of patients across hospitals. The questions were categorized into five domains of patient experience and an overall hospital assessment score as follows: four items addressed communication with nurses, four focused on communication with doctors, five pertained to communication about treatment, two related to the hospital environment, four concerned patient rights, and two evaluated the overall rating of the hospital and the willingness to recommend it. Additionally, three more questions asked patients about their route of admission, self-assessment of overall health, and educational level. With the exception of the 13th question, 19 items utilized a 4-point Likert scale: never, sometimes, usually, and always. Scores were assigned on a continuous scale, with "always" valued at 100 points and "never" at 0 points. The overall rating of the hospital and the willingness to recommend the hospital were assessed on a scale ranging from 0 (worst health status) to 10 (best health status), and these were linearized on a scale from 0 to 100. Total composite scores of patient experience were calculated by summing the scores from each item. Other Variables We analyzed seven patient variables and four hospital-level variables as potential confounders. The patient characteristics included sex, age (categorized as 20–44 years, 45–64 years, or ≥ 65 years), type of health insurance (NHI or Medical Aid), the medical specialty of the hospital (internal medicine or a surgical field), route of admission (whether through the emergency room or not), subjective health status (very good, good, neutral, bad, or very bad), and education (less than middle school graduation, high school graduation, college student, college graduation, or graduate study). The hospital-level variables were the type of hospital (tertiary or secondary hospital), the number of doctors (5 ordinal categories), the number of nurses (5 ordinal categories), and the number of hospital beds (5 ordinal categories). Patient demographic data—including sex, age, type of health insurance, and the field of medical care in the hospital—along with all hospital variables, were identified using NHI claims data accessed through HIRA. Statistical Analysis Descriptive statistics are presented as mean and standard deviation for quantitative variables, and as frequencies or percentages for qualitative variables. The result for each item was calculated, and the total composite score was derived by summing these individual item scores. For comparisons of proportions, the chi-square and Fisher exact tests were employed, while the Student t-test or analysis of variance was used to compare continuous variables. Multiple linear regression models were employed to evaluate the impact of various demographic and hospital-related variables on the overall composite score of patient experience. Beta coefficients, accompanied by p-values, are presented (positive coefficients indicate better patient experience scores). SAS Enterprise version 7.1 (SAS Institute, Cary, NC, USA) was used for all analyses. Results General Characteristics The survey was completed by a total of 97,152 patients who had received inpatient healthcare services and were discharged in the years 2017, 2019, or 2021, with participant numbers for each year being 14,970, 23,924, and 58,258, respectively. Table 1 summarizes the demographic and healthcare-related characteristics of these patients. Table 1 General characteristics of the study population 2017 (n = 14,970) 2019 (n = 23,924) 2021 (n = 58,258) Total (n = 97,152) No. of medical institutions Tertiary hospitals 45 42 45 - Secondary hospitals 50 112 307 - Patients’ characteristics Sex Men 7,472 (49.9) 11,595 (48.5) 29,731 (51.0) 48,798 (50.2) Women 7,498 (50.1) 12,329 (51.5) 28,527 (49.0) 48,354 (49.8) Age (mean ± SD) 56.27 ± 15.61 56.68 ± 15.83 56.68 ± 15.03 56.26 ± 15.32 20–44 years 3,310 (22.1) 5,243 (21.9) 12,646 (21.7) 21,199 (21.8) 45–64 years 6,563 (43.8) 10,353 (43.3) 27,311 (46.9) 44,227 (45.5) ≥ 65 years 5,097 (34.0) 8,328 (34.8) 18,301 (31.4) 31,726 (32.7) Insurance National Health Insurance 13,748 (91.8) 21,794 (91.1) 53,450 (91.7) 88,992 (91.6) Medical Aid 1,222 (8.2) 2,130 (8.9) 4,808 (8.3) 8,160 (8.4) Medical care field Internal medicine 5,358 (35.8) 9,425 (39.4) 23,177 (39.8) 37,960 (39.1) Surgical field 9,612 (64.2) 14,499 (60.6) 35,081 (60.2) 59,192 (60.9) Route of admission Not via the emergency room 9,238 (61.7) 14,427 (60.3) 36,872 (63.3) 60,537 (62.3) Via the emergency room 5,732 (38.3) 9,497 (39.7) 21,386 (36.7) 36,615 (37.7) Subjective health status Very good 2,740 (18.3) 4,114 (17.2) 10,769 (18.5) 17,623 (18.1) Good 4,083 (27.3) 6,208 (25.9) 16,258 (27.9) 26,549 (27.3) Neutral 5,859 (39.1) 9,890 (41.3) 23,361 (40.1) 39,110 (40.3) Bad 1,676 (11.2) 2,730 (11.4) 5,971 (10.2) 10,377 (10.7) Very bad 612 (4.1) 982 (4.1) 1,899 (3.3) 3,493 (3.6) Education Less than middle school graduation 4,483 (29.9) 7,455 (31.2) 14,522 (24.9) 26,460 (27.2) High school graduation 5,405 (36.1) 8,488 (35.5) 22,477 (38.6) 36,370 (37.4) College student or graduation 4,373 (29.2) 6,977 (29.2) 18,562 (31.9) 29,912 (30.8) Graduate study 709 (4.7) 1,004 (4.2) 2,697 (4.6) 4,410 (4.5) Hospital-level factors Type of hospital Tertiary hospital 7,400 (49.4) 7,248 (30.3) 11,305 (19.4) 25,953 (26.7) Secondary hospital 7,570 (50.6) 16,676 (69.7) 46,953 (80.6) 71,199 (73.3) Number of beds < 250 300 (1.3) 14,337 (24.6) 14,637 (15.1) 250–299 1,200 (5.0) 11,612 (19.9) 12,812 (13.2) 300–499 642 (4.3) 7,405 (31.0) 9,663 (16.6) 17,710 (18.2) 500–999 10,779 (72.0) 11,520 (48.2) 17,274 (29.7) 39,573 (40.7) ≥ 1000 3,549 (23.7) 3,499 (14.6) 5,372 (9.2) 12,420 (12.8) Number of doctors < 25 439 (1.8) 11,613 (19.9) 12,052 (12.4) 25–49 623 (4.2) 1,910 (8.0) 14,027 (24.1) 16,560 (17.0) 50–99 1,404 (9.4) 6,530 (27.3) 10,523 (18.1) 18,487 (19.0) 100–249 2,546 (17.0) 4,348 (18.2) 6,549 (11.2) 13,443 (13.8) ≥ 300 10,397 (69.5) 10,697 (44.7) 15,546 (26.7) 36,640 (37.7) Number of nurses < 100 439 (1.8) 9,325 (16.0) 9,764 (15.1) 100–199 550 (3.7) 2,061 (8.6) 14,668 (25.2) 12,279 (13.2) 200–499 1,125 (7.5) 7,280 (30.4) 13,149 (22.6) 21,554 (18.2) 500–949 5,895 (39.4) 6,445 (26.9) 9,811 (16.8) 22,151 (40.7) ≥ 1000 7,400 (49.4) 7,699 (32.2) 11,305 (19.4) 26,404 (12.8) Note: p-value for all variables < .0001 The mean age of the respondents was 56.3 ± 15.3 years, with men constituting 50.2% of the patient population. Additionally, 91.6% of the respondents were covered by the NHI. Over half of the patients (60.9%) underwent surgical treatment, and 37.7% were admitted through the emergency room. Regarding educational attainment, 27.2% of the patients had not completed middle school, 37.4% had a high school diploma, 30.8% had received a college education, and 4.5% held graduate degrees. In terms of perceived health status, 18.1% of participants considered their health to be very good. Meanwhile, 27.3% rated their health as good and 40.3% as neutral. A smaller percentage of participants reported poor (10.7%) or very poor (3.6%) health. Slightly more than one-fourth (26.7%) of all hospitals were tertiary. The mean number of hospital beds was 437.8, the mean number of doctors was 126.4, and the mean number of nurses was 432.5. Patient Experience Scores As shown in Table 2 , the overall composite scores decreased from 83.94 ± 15.98 in 2017 and 83.87 ± 15.79 in 2019 to 83.94 ± 15.98 in 2021. In tertiary hospitals, the total composite scores decreased in 2019 but increased in 2021. Conversely, in secondary hospitals, the overall scores steadily decreased. Table 2 Patient experience score for 5 domains and overall hospital assessment 2017 2019 2021 Total Total composite scores 83.94 ± 15.98 82.72 ± 16.42 82.46 ± 16.25 1. Communication with nurses 88.81 ± 16.64 86.11 ± 18.76 86.38 ± 18.13 2. Communication with doctors 82.31 ± 20.08 81.56 ± 20.11 81.72 ± 19.57 3. Communication about treatment process 82.29 ± 19.93 82.79 ± 19.20 82.30 ± 19.04 4. Hospital environment 87.08 ± 20.54 82.57 ± 20.76 82.82 ± 20.35 5. Assurance of patient rights 82.82 ± 19.24 80.23 ± 20.41 78.77 ± 20.59 6. Overall hospital assessment 83.19 ± 19.57 82.47 ± 20.28 82.26 ± 20.67 Tertiary hospital Total composite scores 84.36 ± 15.53 83.87 ± 15.79 85.28 ± 14.71 1. Communication with nurses 89.52 ± 15.90 87.57 ± 17.62 89.20 ± 16.34 2. Communication with doctors 82.13 ± 20.01 81.74 ± 19.88 83.51 ± 18.34 3. Communication about treatment process 82.91 ± 19.33 83.97 ± 18.38 85.13 ± 17.15 4. Hospital environment 84.61 ± 20.11 84.50 ± 19.53 86.59 ± 18.00 5. Assurance of patient rights 82.99 ± 18.98 81.10 ± 19.92 81.37 ± 19.64 6. Overall hospital assessment 84.06 ± 18.58 84.50 ± 19.53 86.62 ± 16.94 Secondary hospital Total composite scores 83.53 ± 16.39 82.22 ± 16.67 81.78 ± 16.53 1. Communication with nurses 88.11 ± 17.31 85.48 ± 19.20 85.70 ± 18.47 2. Communication with doctors 82.48 ± 20.15 81.49 ± 20.20 81.29 ± 19.83 3. Communication about treatment process 81.68 ± 20.48 82.29 ± 19.53 81.62 ± 19.41 4. Hospital environment 83.56 ± 20.95 81.73 ± 21.22 81.91 ± 20.77 5. Assurance of patient rights 82.66 ± 19.48 79.85 ± 20.60 78.14 ± 20.76 6. Overall hospital assessment 82.34 ± 20.46 81.58 ± 20.75 81.21 ± 21.34 The mean scores for patient experience were highest in the domain of communication with nurses, recording 88.81 points in 2017, 86.11 points in 2019, and 86.38 points in 2021. The lowest scores were observed in the domain of patient rights in 2019 and 2021, with scores of 81.1 and 81.37 respectively, and in the treatment process in 2017, which scored 82.82 points. The scores for the assurance of patient rights steadily decreased. In tertiary hospitals, there was a steady increase in scores for communication about the treatment process and overall hospital assessment. Conversely, in secondary hospitals, scores for communication with doctors, assurance of patient rights, and overall hospital assessment consistently decreased. As illustrated in Fig. 1 , the results for each item in 2017 show that question 1, "How often did nurses treat you with courtesy and respect?" scored the highest at 89.86 points. In contrast, question 17, "Was it easy to talk about complaints during the hospital stay?" scored the lowest at 72.96 points. In subsequent years, 2019 and 2021, question 13, "Did you receive information on which health problems to look out for and which treatment plan to use after you left the hospital?" achieved the highest scores of 93.22 and 92.68 points, respectively. Meanwhile, question 17, "Was it easy to talk about complaints?" remained the lowest, scoring 71.58 and 67.32 points. Overall, scores for most questions showed a yearly decline; however, the score for question 13 consistently increased. The data, including responses from 51,085 patients across 95 hospitals over all three rounds, demonstrated similar patterns. Multivariate Analysis of Factors Associated with a Better Patient Experience Patient experience scores stratified by patient demographic and hospital-related variables are presented in Table 3 . The mean scores were higher among women, younger individuals, and patients who had health insurance, underwent surgical procedures, were admitted to the hospital through non-emergency routes, possessed education beyond a college degree, reported having a health condition, were treated in tertiary hospitals, and had access to a higher number of doctors and nurses, as well as to larger hospital facilities. Table 3 Patient experience score and multiple regression analysis of factors influencing patient experience Overall composite score β coefficient (SD) p-value Sex Men 82.24 Ref. Women 83.27 1.65 (0.12) < .0001 Age 20–44 years 85.12 Ref. 45–64 years 82.12 -0.81 (0.17) < .0001 ≥ 65 years 82.05 -0.46 (0.19) 0.0184 Insurance National Health Insurance 82.92 Ref. Medical Aid 80.86 1.50 (0.23) < .0001 Medical care field Internal medicine 82.17 Ref. Surgical field 83.12 -1.18 (0.13) < .0001 Route of admission Not via the emergency room 83.68 Ref. Via the emergency room 81.20 -3.28 (0.10) < .0001 Subjective health status Very good or good 87.75 12.51 (0.19) < .0001 Neutral 79.65 4.28 (0.19) < .0001 Bad or very bad 75.56 Ref. Education Less than middle school graduation 82.11 Ref. High school graduation 81.60 -1.15 (0.16) < .0001 College student or graduation 84.20 -0.68 (0.19) 0.0003 Graduate study 86.22 0.69 (0.32) 0.0309 Type of hospital Tertiary hospital 84.63 Ref. Secondary hospital 82.07 0.04 (0.03) 0.0944 Number of beds < 250 80.91 Ref. 250–299 80.35 -0.81 (0.24) 0.0007 300–499 82.06 0.56 (0.28) 0.0469 ≥ 500 84.09 1.00 (0.37) 0.0067 Number of doctors < 50 80.57 Ref. 50–99 81.96 -1.05 (0.30) 0.0004 100–249 83.70 -0.74 (0.37) 0.0488 ≥ 300 84.50 -0.87 (0.43) 0.043 Number of nurses < 100 79.10 Ref. 100–199 80.77 0.79 (0.25) 0.0014 200–499 82.42 1.94 (0.35) < .0001 500–949 83.87 2.20 (0.50) < .0001 ≥ 1000 84.72 2.55 (0.55) < .0001 Time - 0.10 (0.05) 0.032 The mean score was higher for women (83.27 points) than for men (82.24 points), and it was also higher among younger individuals. The highest score (85.12 points) was observed in patients aged 20–44 years, while the lowest score (82.05 points) was found in those aged 65 years or older. Regarding educational level, the mean score was highest among patients who had completed graduate studies, decreasing with lower educational levels. For hospital-related variables, the average score was higher in tertiary hospitals, at 84.63 points, compared to 82.07 points in secondary hospitals. The score was highest in hospitals with over 1,000 beds, decreasing as the number of beds decreased. A similar pattern was observed for doctors and nurses: the patient experience score was highest in hospitals employing more than 300 doctors and 1,000 nurses. In the adjusted regression analysis, several factors were associated with a better patient experience response. These included younger age, higher education level, use of Medical Aid, and being in the internal medicine field from the patient's perspective. From the hospital's perspective, factors such as secondary hospital status and a higher number of nurses also correlated positively with patient experience (p < 0.001). However, the number of doctors did not show a statistically significant association (p = 0.0698). Discussion This is the first extensive, representative, population-based study assessing the current patient experience with healthcare in South Korea, with the goal of identifying areas that require improvement. The overall patient experience score appears to have decreased over the 5-year scope of the study. This decline may be attributed to the expansion of participating institutions, which initially included only hospitals with more than 500 beds but later encompassed smaller hospitals with 300 or 100 beds. In tertiary hospitals, the total composite scores decreased in 2019 but increased in 2021, whereas secondary hospitals showed a consistent decline. The scores for most questions decreased annually, but the score for question 13 consistently increased. The overall score for communication with doctors was consistently lower than that for communication with nurses. This gap likely reflects Korea’s low physician-to-patient ratio, which limits the time doctors can spend with each patient. The issue of striking junior doctors has recently become prominent in South Korea, which has one of the lowest doctor-to-patient ratios among Organization for Economic Co-operation and Development (OECD) countries and is facing a rapidly aging population, 17 Projections indicate a shortfall of 15,000 doctors by 2035. In response, the South Korean government proposed increasing the number of medical school admissions by 2,000, raising the total to approximately 5,100 entrants in February 2024. However, this decision has met with significant resistance. Since February 20, 2024, over 10,000 residents and interns have resigned, and numerous medical students have ceased attending classes or declared a leave of absence. 18 The crisis in 2024 stemmed from deeper, longstanding issues in the medical system. This unique aspect of Korean medical culture may explain the low ratings for patients’ relationships with their doctors. Heightened international attention to patient experience over the past decade has prompted many countries to implement national surveys. 19 – 22 Cross-country comparisons, however, remain difficult because patient experience is inherently subjective and shaped by cultural norms and system contexts. Nonetheless, over a 5-year period, we observed improvements in patient experience across hospitals consistently surveyed in South Korea. In England, the National Health Service (NHS) assesses patient experiences in various settings, including inpatient, outpatient, community mental health, and emergency. 19 In an analysis of = 76,000 patients across 144 NHS trusts, 20 , 21 all five domain scores showed a decline in 2018-19 compared to 2017 − 18. 21 In the United States, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was introduced in 2006, with public reporting commencing in 2008. 22 Since 2012, the survey has encompassed 3.0 million patients from over 4,000 hospitals, offering insights into patient experiences. On average, 67.4% of patients reported that they would definitely recommend these hospitals. 22 Meanwhile, in Canada, 62% of respondents described their hospital experience as very good, based on over 90,000 survey responses from more than 300 acute-care hospitals. 23 In China, 95% of patients reported positive experiences with their care. 14 Notably, Korean patients tend to provide more positive responses, a trend that may be attributed to cultural differences. Research on patients' experiences in general practice has revealed that participation in an extended-hours access scheme is only minimally associated with patient experience measures. 11 , 12 , 24 Consistent with previous research, the current study found that a higher level of education correlates with better patient experience ratings. However, unlike earlier work, younger patients tend to report more positive care experiences. 14 This study is the first to analyze the distribution of patient experience measures from a national patient survey over a 5-year period, offering a granular overview of patient experiences and identifying potential areas for improvement in Korean hospitals. We explored the relationships between patient characteristics and factors such as sex, age, health insurance, type of surgery, admission route, education level, and self-reported health condition. Our findings suggest that higher numbers of beds and nurses are associated with better patient experiences. In contrast, a greater number of doctors tends to correlate with lower patient experience ratings. We also analyzed hospital-level factors using claims data, making adjustments for numerous confounding variables related to hospital characteristics, including the number of hospital beds, doctors, and nurses. The positive relationship between nurse staffing levels and patient experience underscores the pivotal role played by nurses in delivering high-quality care. Our study has several key limitations. First, we attempted to measure patient characteristics wherever possible; however, unmeasured confounders, such as cultural differences in patients' personalities and expectations of healthcare, could significantly influence the variations in patient experiences across hospitals. Second, evidence is scant regarding whether collecting data on patient experiences improves the quality of care. Further studies exploring the relationship between patient experiences and the quality of clinical care are necessary in Korea. The results of the fourth experience evaluation, which was completed in November 2023, are currently undergoing data cleaning and are not included in this paper. Our findings indicate that the number of nurses positively influences patient experiences, suggesting that increasing nurse staffing is a pragmatic strategy for improving patient satisfaction in Korean hospitals. Declarations Human ethics approval and consent to participate This study was approved by the Institutional Review Board (IRB) committee of the Health Insurance Review & Assessment Service (HIRA), and adhered to the guidelines of the Declaration of Helsinki. Given the retrospective nature of the study and the anonymity of the data, the Institutional Review Board waived the requirement for written informed consent from all participants (approval number: 2018-015). Consent for publication Not applicable. Availability of data and materials The survey was administered via a web-based platform, with a detailed description available at [https://www.hira.or.kr/ra/eval/asmInfo.do?evlCd=30&pgmid=HIRAA030004000000.]. The dataset, however, is maintained in an internal repository of HIRA. Conflict of Interest All authors declare no competing interests. Funding None Author Contributions YK: writing the manuscript YAJ: writing the manuscript DSK: conceptualization, writing the manuscript, editing the manuscript Acknowledgement None References Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ open 2013; 3 (1). Holmstrom I, Roing M. The relation between patient-centeredness and patient empowerment: a discussion on concepts. Patient education and counseling 2010; 79 (2): 167-72. Bissell P, May CR, Noyce PR. From compliance to concordance: barriers to accomplishing a re-framed model of health care interactions. Social science & medicine 2004; 58 (4): 851-62. Gleeson H, Calderon A, Swami V, Deighton J, Wolpert M, Edbrooke-Childs J. Systematic review of approaches to using patient experience data for quality improvement in healthcare settings. BMJ open 2016; 6 (8): e011907. 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Patterns of patient experience with primary care access in Australia, Canada, New Zealand and Switzerland: a comparative study. International journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua 2019; 31 (9): G126-G32. Talbo MK, Katz A, Dostie M, Legault L, Brazeau AS. Associations Between Socioeconomic Status and Patient Experience With Type 1 Diabetes Management and Complications: Cross-sectional Analysis of a Cohort From Quebec, Canada. Canadian journal of diabetes 2022. OECD. OECD Health Statistics. Paris: OECD Publishing; 2023. Dyer O. South Korea: Striking junior doctors are threatened with arrest and suspension. Bmj 2024; 384 : q495. NHS. Overall Patient Experience Scores. London: NHS England, 2020. Honeyford K, Greaves F, Aylin P, Bottle A. Secondary analysis of hospital patient experience scores across England's National Health Service - How much has improved since 2005? PloS one 2017; 12 (10): e0187012. England N. Overall Patient Experience Scores: 2018 Adult Inpatient Survey update. 2019. Jha AK, Orav EJ, Zheng J, Epstein AM. Patients' perception of hospital care in the United States. The New England journal of medicine 2008; 359 (18): 1921-31. Davidson MJ, Lacroix J, McMartin S, Kudhail R, Hart K, Diestelkamp N. Patient Experiencces in Canadian Hospitals. Healthcare Quartely 2019; 22 (3): 12-4. Cowling TE, Laverty AA, Harris MJ, Watt HC, Greaves F, Majeed A. Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey. Journal of the Royal Society of Medicine 2017; 110 (11): 440-51. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 04 Sep, 2025 Reviewers agreed at journal 25 Aug, 2025 Reviewers invited by journal 14 Aug, 2025 Editor assigned by journal 13 Aug, 2025 Editor invited by journal 28 Jul, 2025 Submission checks completed at journal 28 Jul, 2025 First submitted to journal 28 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7106896","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":502689915,"identity":"495e88de-afa4-40db-83bf-3f5a7b10e217","order_by":0,"name":"Yangjoong Kim","email":"","orcid":"","institution":"Health Insurance Review and Assessment Service","correspondingAuthor":false,"prefix":"","firstName":"Yangjoong","middleName":"","lastName":"Kim","suffix":""},{"id":502689916,"identity":"d6701e3a-a21d-49a9-9888-7abdde721ace","order_by":1,"name":"Young-Ae Jeong","email":"","orcid":"","institution":"Health Insurance Review and Assessment Service","correspondingAuthor":false,"prefix":"","firstName":"Young-Ae","middleName":"","lastName":"Jeong","suffix":""},{"id":502689917,"identity":"1d31e6c9-dcf1-448d-9498-ab7e5d5252ed","order_by":2,"name":"Dong-Sook Kim","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAy0lEQVRIiWNgGAWjYPACmwQwlVBAjGI2ZhCZBtViABIhTsthiBYGYrTIz+8/+Lig4nwe/+zuxA8PDBjy+OUb8GsxOMbMbDzjzO1iiTtnN0sAHVYs2UbAFgM2ZjZp3rbbiQ03cjeAtCRuOEbIYW0gLf/OJc6/kbv5B0jLfkJaGI6BtDQcSNxwI3cbxBZC3jc4lmxszHMsOXEjUItFgoFE4oxjCQQc1nzw4WOeGrvEeUCH3fxRYZPY33yAkMtQgQRpykfBKBgFo2AUYAcAocpB5nvKzekAAAAASUVORK5CYII=","orcid":"","institution":"Kongju National University","correspondingAuthor":true,"prefix":"","firstName":"Dong-Sook","middleName":"","lastName":"Kim","suffix":""}],"badges":[],"createdAt":"2025-07-12 08:53:02","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7106896/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7106896/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":89656263,"identity":"8a83f2e4-3a4e-4baa-bca4-f397a8e69b22","added_by":"auto","created_at":"2025-08-22 10:28:21","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":245149,"visible":true,"origin":"","legend":"\u003cp\u003ePatient experience evaluated using 21 items\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-7106896/v1/52f187718fba7498f2fb5ae2.jpg"},{"id":89658647,"identity":"0a84b3ec-0730-46dd-a632-887b375182b5","added_by":"auto","created_at":"2025-08-22 10:44:26","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1355262,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7106896/v1/c6fd8aaf-1bff-43e0-aa18-0de4fdfcd31c.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Patient Experiences of Hospital Care in South Korea in Three Biennial National Surveys from 2017 to 2021 Running Title: Patient Experiences in Korea","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe rapid aging of the population is driving a sharp rise in multimorbidity. Empowering individuals through tailored information and shared decision-making has proved effective in chronic diseases.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e Patient experience and healthcare quality are key measures for improving clinical outcomes.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e Treating patients as partners in their healthcare \u003csup\u003e\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e has elevated the importance of interactions between healthcare professionals and patients for both treatment outcomes and patient well-being.\u003csup\u003e\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e–\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e Avedis Donabedian, a prominent figure in this field, identified three components of healthcare quality: technical quality, which refers to the effectiveness of care in achieving possible health improvements; interpersonal quality, which involves accommodating patient needs and preferences; and amenities, which include physical surroundings and organizational attributes. However, contemporary quality initiatives still privilege technical metrics, often overlooking the interpersonal and environmental domains that matter most to patients.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eInteractions between healthcare providers and patients are sometimes underestimated, and assessments of those interactions often fail to address the complexities involved in quality of care. This can blunt the impact of even substantial resource investment in structural and procedural aspects. A systematic review linked superior patient experience to better clinical outcomes.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e This evidence has intensified interest in how the patient experience relates to quality of care.\u003c/p\u003e\u003cp\u003eAs early as 1977, the World Health Organization (WHO) advocated for patient participation in their own healthcare.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e The ensuing movements toward patient-centeredness and empowerment have expanded patient autonomy in clinical decisions.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e,\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e Over the past decade, many health systems have embedded patient-reported experience measures (PREMs) into quality-improvement programs, using them to steer reforms that prioritise patient satisfaction and overall care quality.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eAfter achieving universal health insurance coverage through the National Health Insurance (NHI) program in 1989 \u003csup\u003e8\u003c/sup\u003e, South Korea tasked the Health Insurance Review \u0026amp; Assessment Service (HIRA) in South Korea with reviewing patient experiences to enhance healthcare quality. In 2017, HIRA launched a nationwide PREM-based patient experience survey as part of its healthcare quality assessment program. The Korean government adopted the classic framework on quality of care developed by Donabedian\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e and the Institute of Medicine in the United States, initiating the QA program in 2001. This program encompasses 36 areas and is implemented across a spectrum of conditions, including acute diseases like stroke and pneumonia, chronic diseases such as hypertension, diabetes, chronic obstructive pulmonary disease, asthma, and cancer, as well as antibiotic use for respiratory diseases and long-term care within Korea.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe outcomes of PREMs have been researched in the USA, Canada, England, and China.\u003csup\u003e\u003cspan additionalcitationids=\"CR12 CR13 CR14 CR15\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e–\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e In Korea, despite three government-conducted patient experience evaluations, no study has yet provided a comprehensive analysis of the nationwide patient experience survey. Additionally, there has been limited research into the patient and hospital-level factors that influence patient experience.\u003c/p\u003e\u003cp\u003eThis study explored the current state of patients’ experiences with healthcare and sought to identify areas for improvement by analyzing survey data from South Korea. We also examined patient- and hospital-level factors that influence the patient experience.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cb\u003eData and study population\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThis cross-sectional study involved administering a representative survey to discharged patients aged 20 years and older in hospitals, utilizing the Korean National Patient Experience Survey (KNPES) across three years: 2017, 2019, and 2021. Inpatients from the Departments of Pediatrics and Psychiatry were excluded from the study. The selection criteria for target hospitals varied: in 2017, hospitals with 500 or more beds were included; in 2019, the criteria were adjusted to include hospitals with 300 or more beds; and in 2021, the study focused on tertiary general hospitals and general hospitals with at least 100 beds.\u003c/p\u003e\u003cp\u003eThe target patients had been hospitalized for more than one overnight stay in tertiary and secondary hospitals and were discharged within a period ranging from 2 days to 8 weeks. Telephone surveys were conducted in three separate periods: between July and October 2017, May and November 2019, and May and November 2020. Each patient's phone number was obtained upon request from the respective hospital. The discharged patients were categorized based on the type of hospital and the number of beds available, with survey data collected from 150 to 250 patients per hospital.\u003c/p\u003e\u003cp\u003e\u003cb\u003eSurvey Instrument\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe KNPES consists of 24 items (Supplementary material). Nineteen items across 5 domains measure aspects of the hospital experience, and there are two overall hospital assessment items and three individual items to adjust for the mix of patients across hospitals.\u003c/p\u003e\u003cp\u003eThe questions were categorized into five domains of patient experience and an overall hospital assessment score as follows: four items addressed communication with nurses, four focused on communication with doctors, five pertained to communication about treatment, two related to the hospital environment, four concerned patient rights, and two evaluated the overall rating of the hospital and the willingness to recommend it. Additionally, three more questions asked patients about their route of admission, self-assessment of overall health, and educational level.\u003c/p\u003e\u003cp\u003eWith the exception of the 13th question, 19 items utilized a 4-point Likert scale: never, sometimes, usually, and always. Scores were assigned on a continuous scale, with \"always\" valued at 100 points and \"never\" at 0 points. The overall rating of the hospital and the willingness to recommend the hospital were assessed on a scale ranging from 0 (worst health status) to 10 (best health status), and these were linearized on a scale from 0 to 100. Total composite scores of patient experience were calculated by summing the scores from each item.\u003c/p\u003e\u003cp\u003e\u003cb\u003eOther Variables\u003c/b\u003e\u003c/p\u003e\u003cp\u003eWe analyzed seven patient variables and four hospital-level variables as potential confounders. The patient characteristics included sex, age (categorized as 20–44 years, 45–64 years, or ≥ 65 years), type of health insurance (NHI or Medical Aid), the medical specialty of the hospital (internal medicine or a surgical field), route of admission (whether through the emergency room or not), subjective health status (very good, good, neutral, bad, or very bad), and education (less than middle school graduation, high school graduation, college student, college graduation, or graduate study).\u003c/p\u003e\u003cp\u003eThe hospital-level variables were the type of hospital (tertiary or secondary hospital), the number of doctors (5 ordinal categories), the number of nurses (5 ordinal categories), and the number of hospital beds (5 ordinal categories).\u003c/p\u003e\u003cp\u003ePatient demographic data—including sex, age, type of health insurance, and the field of medical care in the hospital—along with all hospital variables, were identified using NHI claims data accessed through HIRA.\u003c/p\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eDescriptive statistics are presented as mean and standard deviation for quantitative variables, and as frequencies or percentages for qualitative variables. The result for each item was calculated, and the total composite score was derived by summing these individual item scores. For comparisons of proportions, the chi-square and Fisher exact tests were employed, while the Student t-test or analysis of variance was used to compare continuous variables.\u003c/p\u003e\u003cp\u003eMultiple linear regression models were employed to evaluate the impact of various demographic and hospital-related variables on the overall composite score of patient experience. Beta coefficients, accompanied by p-values, are presented (positive coefficients indicate better patient experience scores).\u003c/p\u003e\u003cp\u003eSAS Enterprise version 7.1 (SAS Institute, Cary, NC, USA) was used for all analyses.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cb\u003eGeneral Characteristics\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe survey was completed by a total of 97,152 patients who had received inpatient healthcare services and were discharged in the years 2017, 2019, or 2021, with participant numbers for each year being 14,970, 23,924, and 58,258, respectively. Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e summarizes the demographic and healthcare-related characteristics of these patients.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eGeneral characteristics of the study population\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e2017\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;14,970)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e2019\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;23,924)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003e2021\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;58,258)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;97,152)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo. of medical institutions\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTertiary hospitals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003e45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary hospitals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003e50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003e112\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003e307\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePatients\u0026rsquo; characteristics\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7,472\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(49.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11,595\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(48.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e29,731\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(51.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e48,798\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(50.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWomen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7,498\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(50.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12,329\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(51.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28,527\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(49.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e48,354\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(49.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e56.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026plusmn;\u0026thinsp;15.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e56.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026plusmn;\u0026thinsp;15.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e56.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026plusmn;\u0026thinsp;15.03\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e56.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u0026plusmn;\u0026thinsp;15.32\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u0026ndash;44 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3,310\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(22.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5,243\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(21.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e12,646\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(21.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e21,199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(21.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;64 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6,563\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(43.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10,353\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(43.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e27,311\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(46.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e44,227\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(45.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;65 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5,097\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(34.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8,328\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(34.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18,301\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(31.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e31,726\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(32.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInsurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNational Health Insurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e13,748\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(91.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21,794\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(91.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e53,450\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(91.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e88,992\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(91.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical Aid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,222\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(8.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2,130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(8.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4,808\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(8.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e8,160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(8.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical care field\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternal medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5,358\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(35.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9,425\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(39.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e23,177\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(39.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e37,960\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(39.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical field\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9,612\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(64.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14,499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(60.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e35,081\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(60.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e59,192\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(60.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRoute of admission\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot via the emergency room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e9,238\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(61.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e14,427\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(60.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36,872\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(63.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e60,537\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(62.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVia the emergency room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5,732\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(38.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9,497\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(39.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e21,386\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(36.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e36,615\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(37.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSubjective health status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVery good\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2,740\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(18.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4,114\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(17.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10,769\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(18.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e17,623\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(18.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4,083\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(27.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6,208\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(25.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e16,258\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(27.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e26,549\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(27.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5,859\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(39.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9,890\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(41.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e23,361\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(40.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e39,110\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(40.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBad\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,676\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(11.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2,730\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(11.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5,971\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(10.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e10,377\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(10.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVery bad\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e612\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e982\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1,899\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(3.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e3,493\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(3.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLess than middle school graduation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4,483\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(29.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7,455\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(31.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14,522\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(24.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e26,460\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(27.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh school graduation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5,405\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(36.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8,488\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(35.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e22,477\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(38.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e36,370\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(37.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCollege student or graduation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4,373\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(29.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6,977\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(29.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18,562\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(31.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e29,912\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(30.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGraduate study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e709\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(4.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1,004\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(4.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e2,697\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(4.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e4,410\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(4.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHospital-level factors\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType of hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTertiary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7,400\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(49.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7,248\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(30.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11,305\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(19.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e25,953\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(26.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7,570\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(50.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e16,676\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(69.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e46,953\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(80.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e71,199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(73.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of beds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;250\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(1.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14,337\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(24.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e14,637\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(15.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e250\u0026ndash;299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1,200\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(5.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11,612\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(19.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e12,812\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(13.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e300\u0026ndash;499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e642\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(4.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7,405\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(31.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9,663\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(16.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e17,710\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(18.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e500\u0026ndash;999\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10,779\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(72.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e11,520\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(48.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17,274\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(29.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e39,573\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(40.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;1000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3,549\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(23.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3,499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(14.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e5,372\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(9.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e12,420\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(12.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of doctors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(1.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11,613\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(19.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e12,052\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(12.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e25\u0026ndash;49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e623\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(4.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1,910\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(8.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14,027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(24.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e16,560\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(17.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e50\u0026ndash;99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,404\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(9.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6,530\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(27.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e10,523\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(18.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e18,487\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(19.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e100\u0026ndash;249\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2,546\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(17.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4,348\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(18.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6,549\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(11.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e13,443\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(13.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10,397\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(69.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e10,697\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(44.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e15,546\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e36,640\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(37.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e439\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(1.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9,325\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(16.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e9,764\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(15.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e100\u0026ndash;199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e550\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(3.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2,061\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(8.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e14,668\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(25.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e12,279\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(13.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e200\u0026ndash;499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1,125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(7.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7,280\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(30.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e13,149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(22.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e21,554\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(18.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e500\u0026ndash;949\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5,895\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(39.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6,445\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(26.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9,811\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(16.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e22,151\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(40.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;1000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7,400\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(49.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e7,699\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(32.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11,305\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(19.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e26,404\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e(12.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003eNote: p-value for all variables\u0026thinsp;\u0026lt;\u0026thinsp;.0001\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe mean age of the respondents was 56.3\u0026thinsp;\u0026plusmn;\u0026thinsp;15.3 years, with men constituting 50.2% of the patient population. Additionally, 91.6% of the respondents were covered by the NHI. Over half of the patients (60.9%) underwent surgical treatment, and 37.7% were admitted through the emergency room. Regarding educational attainment, 27.2% of the patients had not completed middle school, 37.4% had a high school diploma, 30.8% had received a college education, and 4.5% held graduate degrees. In terms of perceived health status, 18.1% of participants considered their health to be very good. Meanwhile, 27.3% rated their health as good and 40.3% as neutral. A smaller percentage of participants reported poor (10.7%) or very poor (3.6%) health.\u003c/p\u003e\u003cp\u003eSlightly more than one-fourth (26.7%) of all hospitals were tertiary. The mean number of hospital beds was 437.8, the mean number of doctors was 126.4, and the mean number of nurses was 432.5.\u003c/p\u003e\u003cp\u003e\u003cb\u003ePatient Experience Scores\u003c/b\u003e\u003c/p\u003e\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, the overall composite scores decreased from 83.94\u0026thinsp;\u0026plusmn;\u0026thinsp;15.98 in 2017 and 83.87\u0026thinsp;\u0026plusmn;\u0026thinsp;15.79 in 2019 to 83.94\u0026thinsp;\u0026plusmn;\u0026thinsp;15.98 in 2021. In tertiary hospitals, the total composite scores decreased in 2019 but increased in 2021. Conversely, in secondary hospitals, the overall scores steadily decreased.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePatient experience score for 5 domains and overall hospital assessment\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"4\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2017\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2019\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2021\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal composite scores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e83.94\u0026thinsp;\u0026plusmn;\u0026thinsp;15.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e82.72\u0026thinsp;\u0026plusmn;\u0026thinsp;16.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e82.46\u0026thinsp;\u0026plusmn;\u0026thinsp;16.25\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. Communication with nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e88.81\u0026thinsp;\u0026plusmn;\u0026thinsp;16.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e86.11\u0026thinsp;\u0026plusmn;\u0026thinsp;18.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e86.38\u0026thinsp;\u0026plusmn;\u0026thinsp;18.13\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. Communication with doctors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.31\u0026thinsp;\u0026plusmn;\u0026thinsp;20.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e81.56\u0026thinsp;\u0026plusmn;\u0026thinsp;20.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e81.72\u0026thinsp;\u0026plusmn;\u0026thinsp;19.57\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. Communication about treatment process\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.29\u0026thinsp;\u0026plusmn;\u0026thinsp;19.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e82.79\u0026thinsp;\u0026plusmn;\u0026thinsp;19.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e82.30\u0026thinsp;\u0026plusmn;\u0026thinsp;19.04\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. Hospital environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e87.08\u0026thinsp;\u0026plusmn;\u0026thinsp;20.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e82.57\u0026thinsp;\u0026plusmn;\u0026thinsp;20.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e82.82\u0026thinsp;\u0026plusmn;\u0026thinsp;20.35\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. Assurance of patient rights\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.82\u0026thinsp;\u0026plusmn;\u0026thinsp;19.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e80.23\u0026thinsp;\u0026plusmn;\u0026thinsp;20.41\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e78.77\u0026thinsp;\u0026plusmn;\u0026thinsp;20.59\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. Overall hospital assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e83.19\u0026thinsp;\u0026plusmn;\u0026thinsp;19.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e82.47\u0026thinsp;\u0026plusmn;\u0026thinsp;20.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e82.26\u0026thinsp;\u0026plusmn;\u0026thinsp;20.67\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTertiary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal composite scores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e84.36\u0026thinsp;\u0026plusmn;\u0026thinsp;15.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e83.87\u0026thinsp;\u0026plusmn;\u0026thinsp;15.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e85.28\u0026thinsp;\u0026plusmn;\u0026thinsp;14.71\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. Communication with nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e89.52\u0026thinsp;\u0026plusmn;\u0026thinsp;15.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e87.57\u0026thinsp;\u0026plusmn;\u0026thinsp;17.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e89.20\u0026thinsp;\u0026plusmn;\u0026thinsp;16.34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. Communication with doctors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.13\u0026thinsp;\u0026plusmn;\u0026thinsp;20.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e81.74\u0026thinsp;\u0026plusmn;\u0026thinsp;19.88\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e83.51\u0026thinsp;\u0026plusmn;\u0026thinsp;18.34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. Communication about treatment process\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.91\u0026thinsp;\u0026plusmn;\u0026thinsp;19.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e83.97\u0026thinsp;\u0026plusmn;\u0026thinsp;18.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e85.13\u0026thinsp;\u0026plusmn;\u0026thinsp;17.15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. Hospital environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e84.61\u0026thinsp;\u0026plusmn;\u0026thinsp;20.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e84.50\u0026thinsp;\u0026plusmn;\u0026thinsp;19.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e86.59\u0026thinsp;\u0026plusmn;\u0026thinsp;18.00\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. Assurance of patient rights\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.99\u0026thinsp;\u0026plusmn;\u0026thinsp;18.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e81.10\u0026thinsp;\u0026plusmn;\u0026thinsp;19.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e81.37\u0026thinsp;\u0026plusmn;\u0026thinsp;19.64\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. Overall hospital assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e84.06\u0026thinsp;\u0026plusmn;\u0026thinsp;18.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e84.50\u0026thinsp;\u0026plusmn;\u0026thinsp;19.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e86.62\u0026thinsp;\u0026plusmn;\u0026thinsp;16.94\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTotal composite scores\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e83.53\u0026thinsp;\u0026plusmn;\u0026thinsp;16.39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e82.22\u0026thinsp;\u0026plusmn;\u0026thinsp;16.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e81.78\u0026thinsp;\u0026plusmn;\u0026thinsp;16.53\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1. Communication with nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e88.11\u0026thinsp;\u0026plusmn;\u0026thinsp;17.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e85.48\u0026thinsp;\u0026plusmn;\u0026thinsp;19.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e85.70\u0026thinsp;\u0026plusmn;\u0026thinsp;18.47\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e2. Communication with doctors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.48\u0026thinsp;\u0026plusmn;\u0026thinsp;20.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e81.49\u0026thinsp;\u0026plusmn;\u0026thinsp;20.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e81.29\u0026thinsp;\u0026plusmn;\u0026thinsp;19.83\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3. Communication about treatment process\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e81.68\u0026thinsp;\u0026plusmn;\u0026thinsp;20.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e82.29\u0026thinsp;\u0026plusmn;\u0026thinsp;19.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e81.62\u0026thinsp;\u0026plusmn;\u0026thinsp;19.41\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e4. Hospital environment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e83.56\u0026thinsp;\u0026plusmn;\u0026thinsp;20.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e81.73\u0026thinsp;\u0026plusmn;\u0026thinsp;21.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e81.91\u0026thinsp;\u0026plusmn;\u0026thinsp;20.77\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5. Assurance of patient rights\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.66\u0026thinsp;\u0026plusmn;\u0026thinsp;19.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e79.85\u0026thinsp;\u0026plusmn;\u0026thinsp;20.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e78.14\u0026thinsp;\u0026plusmn;\u0026thinsp;20.76\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e6. Overall hospital assessment\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e82.34\u0026thinsp;\u0026plusmn;\u0026thinsp;20.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e81.58\u0026thinsp;\u0026plusmn;\u0026thinsp;20.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e81.21\u0026thinsp;\u0026plusmn;\u0026thinsp;21.34\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe mean scores for patient experience were highest in the domain of communication with nurses, recording 88.81 points in 2017, 86.11 points in 2019, and 86.38 points in 2021. The lowest scores were observed in the domain of patient rights in 2019 and 2021, with scores of 81.1 and 81.37 respectively, and in the treatment process in 2017, which scored 82.82 points. The scores for the assurance of patient rights steadily decreased.\u003c/p\u003e\u003cp\u003eIn tertiary hospitals, there was a steady increase in scores for communication about the treatment process and overall hospital assessment. Conversely, in secondary hospitals, scores for communication with doctors, assurance of patient rights, and overall hospital assessment consistently decreased.\u003c/p\u003e\u003cp\u003eAs illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, the results for each item in 2017 show that question 1, \"How often did nurses treat you with courtesy and respect?\" scored the highest at 89.86 points. In contrast, question 17, \"Was it easy to talk about complaints during the hospital stay?\" scored the lowest at 72.96 points. In subsequent years, 2019 and 2021, question 13, \"Did you receive information on which health problems to look out for and which treatment plan to use after you left the hospital?\" achieved the highest scores of 93.22 and 92.68 points, respectively. Meanwhile, question 17, \"Was it easy to talk about complaints?\" remained the lowest, scoring 71.58 and 67.32 points. Overall, scores for most questions showed a yearly decline; however, the score for question 13 consistently increased. The data, including responses from 51,085 patients across 95 hospitals over all three rounds, demonstrated similar patterns.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cb\u003eMultivariate Analysis of Factors Associated with a Better Patient Experience\u003c/b\u003e\u003c/p\u003e\u003cp\u003ePatient experience scores stratified by patient demographic and hospital-related variables are presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. The mean scores were higher among women, younger individuals, and patients who had health insurance, underwent surgical procedures, were admitted to the hospital through non-emergency routes, possessed education beyond a college degree, reported having a health condition, were treated in tertiary hospitals, and had access to a higher number of doctors and nurses, as well as to larger hospital facilities.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePatient experience score and multiple regression analysis of factors influencing patient experience\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOverall composite score\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eβ coefficient (SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSex\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWomen\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e83.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.12)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e20\u0026ndash;44 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e85.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e45\u0026ndash;64 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.17)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;65 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0184\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInsurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNational Health Insurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.92\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical Aid\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.23)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical care field\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eInternal medicine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.17\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSurgical field\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e83.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-1.18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.13)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRoute of admission\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot via the emergency room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e83.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVia the emergency room\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e81.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-3.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.10)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSubjective health status\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVery good or good\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e87.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNeutral\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e79.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBad or very bad\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e75.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLess than middle school graduation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.11\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh school graduation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e81.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-1.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.16)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCollege student or graduation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e84.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.19)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGraduate study\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e86.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.69\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.32)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0309\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eType of hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTertiary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e84.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary hospital\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.04\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.03)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0944\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of beds\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;250\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80.91\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e250\u0026ndash;299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.81\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.24)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0007\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e300\u0026ndash;499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.28)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0469\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;500\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e84.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.37)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0067\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of doctors\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e50\u0026ndash;99\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e81.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-1.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.30)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0004\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e100\u0026ndash;249\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e83.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.37)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0488\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;300\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e84.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e-0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.43)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.043\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNumber of nurses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e79.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eRef.\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e100\u0026ndash;199\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.25)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.0014\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e200\u0026ndash;499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e82.42\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.94\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.35)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e500\u0026ndash;949\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e83.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.50)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;1000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e84.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.55)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;.0001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTime\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e(0.05)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.032\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe mean score was higher for women (83.27 points) than for men (82.24 points), and it was also higher among younger individuals. The highest score (85.12 points) was observed in patients aged 20\u0026ndash;44 years, while the lowest score (82.05 points) was found in those aged 65 years or older. Regarding educational level, the mean score was highest among patients who had completed graduate studies, decreasing with lower educational levels.\u003c/p\u003e\u003cp\u003eFor hospital-related variables, the average score was higher in tertiary hospitals, at 84.63 points, compared to 82.07 points in secondary hospitals. The score was highest in hospitals with over 1,000 beds, decreasing as the number of beds decreased. A similar pattern was observed for doctors and nurses: the patient experience score was highest in hospitals employing more than 300 doctors and 1,000 nurses.\u003c/p\u003e\u003cp\u003eIn the adjusted regression analysis, several factors were associated with a better patient experience response. These included younger age, higher education level, use of Medical Aid, and being in the internal medicine field from the patient's perspective. From the hospital's perspective, factors such as secondary hospital status and a higher number of nurses also correlated positively with patient experience (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). However, the number of doctors did not show a statistically significant association (p\u0026thinsp;=\u0026thinsp;0.0698).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis is the first extensive, representative, population-based study assessing the current patient experience with healthcare in South Korea, with the goal of identifying areas that require improvement.\u003c/p\u003e\u003cp\u003eThe overall patient experience score appears to have decreased over the 5-year scope of the study. This decline may be attributed to the expansion of participating institutions, which initially included only hospitals with more than 500 beds but later encompassed smaller hospitals with 300 or 100 beds. In tertiary hospitals, the total composite scores decreased in 2019 but increased in 2021, whereas secondary hospitals showed a consistent decline. The scores for most questions decreased annually, but the score for question 13 consistently increased.\u003c/p\u003e\u003cp\u003eThe overall score for communication with doctors was consistently lower than that for communication with nurses. This gap likely reflects Korea\u0026rsquo;s low physician-to-patient ratio, which limits the time doctors can spend with each patient.\u003c/p\u003e\u003cp\u003eThe issue of striking junior doctors has recently become prominent in South Korea, which has one of the lowest doctor-to-patient ratios among Organization for Economic Co-operation and Development (OECD) countries and is facing a rapidly aging population,\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e Projections indicate a shortfall of 15,000 doctors by 2035. In response, the South Korean government proposed increasing the number of medical school admissions by 2,000, raising the total to approximately 5,100 entrants in February 2024. However, this decision has met with significant resistance. Since February 20, 2024, over 10,000 residents and interns have resigned, and numerous medical students have ceased attending classes or declared a leave of absence.\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThe crisis in 2024 stemmed from deeper, longstanding issues in the medical system. This unique aspect of Korean medical culture may explain the low ratings for patients\u0026rsquo; relationships with their doctors.\u003c/p\u003e\u003cp\u003eHeightened international attention to patient experience over the past decade has prompted many countries to implement national surveys.\u003csup\u003e\u003cspan additionalcitationids=\"CR20 CR21\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e Cross-country comparisons, however, remain difficult because patient experience is inherently subjective and shaped by cultural norms and system contexts. Nonetheless, over a 5-year period, we observed improvements in patient experience across hospitals consistently surveyed in South Korea.\u003c/p\u003e\u003cp\u003eIn England, the National Health Service (NHS) assesses patient experiences in various settings, including inpatient, outpatient, community mental health, and emergency.\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e In an analysis of =\u0026thinsp;76,000 patients across 144 NHS trusts,\u003csup\u003e\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e,\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e all five domain scores showed a decline in 2018-19 compared to 2017\u0026thinsp;\u0026minus;\u0026thinsp;18.\u003csup\u003e21\u003c/sup\u003e In the United States, the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was introduced in 2006, with public reporting commencing in 2008.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e Since 2012, the survey has encompassed 3.0\u0026nbsp;million patients from over 4,000 hospitals, offering insights into patient experiences. On average, 67.4% of patients reported that they would definitely recommend these hospitals.\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e Meanwhile, in Canada, 62% of respondents described their hospital experience as very good, based on over 90,000 survey responses from more than 300 acute-care hospitals.\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u003c/sup\u003e In China, 95% of patients reported positive experiences with their care.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e Notably, Korean patients tend to provide more positive responses, a trend that may be attributed to cultural differences.\u003c/p\u003e\u003cp\u003eResearch on patients' experiences in general practice has revealed that participation in an extended-hours access scheme is only minimally associated with patient experience measures.\u003csup\u003e\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e,\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e Consistent with previous research, the current study found that a higher level of education correlates with better patient experience ratings. However, unlike earlier work, younger patients tend to report more positive care experiences.\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eThis study is the first to analyze the distribution of patient experience measures from a national patient survey over a 5-year period, offering a granular overview of patient experiences and identifying potential areas for improvement in Korean hospitals. We explored the relationships between patient characteristics and factors such as sex, age, health insurance, type of surgery, admission route, education level, and self-reported health condition. Our findings suggest that higher numbers of beds and nurses are associated with better patient experiences. In contrast, a greater number of doctors tends to correlate with lower patient experience ratings.\u003c/p\u003e\u003cp\u003eWe also analyzed hospital-level factors using claims data, making adjustments for numerous confounding variables related to hospital characteristics, including the number of hospital beds, doctors, and nurses. The positive relationship between nurse staffing levels and patient experience underscores the pivotal role played by nurses in delivering high-quality care.\u003c/p\u003e\u003cp\u003eOur study has several key limitations. First, we attempted to measure patient characteristics wherever possible; however, unmeasured confounders, such as cultural differences in patients' personalities and expectations of healthcare, could significantly influence the variations in patient experiences across hospitals. Second, evidence is scant regarding whether collecting data on patient experiences improves the quality of care. Further studies exploring the relationship between patient experiences and the quality of clinical care are necessary in Korea. The results of the fourth experience evaluation, which was completed in November 2023, are currently undergoing data cleaning and are not included in this paper.\u003c/p\u003e\u003cp\u003eOur findings indicate that the number of nurses positively influences patient experiences, suggesting that increasing nurse staffing is a pragmatic strategy for improving patient satisfaction in Korean hospitals.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eHuman ethics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study was approved by the Institutional Review Board (IRB) committee of the Health Insurance Review \u0026amp; Assessment Service (HIRA), and adhered to the guidelines of the Declaration of Helsinki. Given the retrospective nature of the study and the anonymity of the data, the Institutional Review Board waived the requirement for written informed consent from all participants (approval number: 2018-015).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe survey was administered via a web-based platform, with a detailed description available at [https://www.hira.or.kr/ra/eval/asmInfo.do?evlCd=30\u0026amp;pgmid=HIRAA030004000000.]. The dataset, however, is maintained in an internal repository of HIRA.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eYK: writing the manuscript\u003c/p\u003e\n\u003cp\u003eYAJ: writing the manuscript\u003c/p\u003e\n\u003cp\u003eDSK: conceptualization, writing the manuscript, editing the manuscript\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNone\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eDoyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. \u003cem\u003eBMJ open\u003c/em\u003e 2013; \u003cstrong\u003e3\u003c/strong\u003e(1).\u003c/li\u003e\n\u003cli\u003eHolmstrom I, Roing M. The relation between patient-centeredness and patient empowerment: a discussion on concepts. \u003cem\u003ePatient education and counseling\u003c/em\u003e 2010; \u003cstrong\u003e79\u003c/strong\u003e(2): 167-72.\u003c/li\u003e\n\u003cli\u003eBissell P, May CR, Noyce PR. From compliance to concordance: barriers to accomplishing a re-framed model of health care interactions. \u003cem\u003eSocial science \u0026amp; medicine\u003c/em\u003e 2004; \u003cstrong\u003e58\u003c/strong\u003e(4): 851-62.\u003c/li\u003e\n\u003cli\u003eGleeson H, Calderon A, Swami V, Deighton J, Wolpert M, Edbrooke-Childs J. Systematic review of approaches to using patient experience data for quality improvement in healthcare settings. \u003cem\u003eBMJ open\u003c/em\u003e 2016; \u003cstrong\u003e6\u003c/strong\u003e(8): e011907.\u003c/li\u003e\n\u003cli\u003eLittle P, Everitt H, Williamson I, et al. Observational study of effect of patient centredness and positive approach on outcomes of general practice consultations. \u003cem\u003eBmj\u003c/em\u003e 2001; \u003cstrong\u003e323\u003c/strong\u003e(7318): 908-11.\u003c/li\u003e\n\u003cli\u003eLittle P, Everitt H, Williamson I, et al. Preferences of patients for patient centred approach to consultation in primary care: observational study. \u003cem\u003eBmj\u003c/em\u003e 2001; \u003cstrong\u003e322\u003c/strong\u003e(7284): 468-72.\u003c/li\u003e\n\u003cli\u003ePark J, Moon K, Kim DS. Health Care Utilization and Anti-Cancer Drug Expenditure for Six Solid Cancers in Korea From 2007 to 2019. \u003cem\u003eFrontiers in oncology\u003c/em\u003e 2022; \u003cstrong\u003e12\u003c/strong\u003e: 862173.\u003c/li\u003e\n\u003cli\u003ePark D, Lee H, Kim DS. High-Cost Users of Prescription Drugs: National Health Insurance Data from South Korea. \u003cem\u003eJournal of general internal medicine\u003c/em\u003e 2021.\u003c/li\u003e\n\u003cli\u003eA D. Explorations in quality assessment and monitoring. the definition of quality and approaches to its assessment. Chicago: Health Administration Press; 1980.\u003c/li\u003e\n\u003cli\u003eKorea Healthcare Quality Assessment. 2023. https://khqa.kr/main.\u003c/li\u003e\n\u003cli\u003eCowling TE, Harris M, Majeed A. Extended opening hours and patient experience of general practice in England: multilevel regression analysis of a national patient survey. \u003cem\u003eBMJ quality \u0026amp; safety\u003c/em\u003e 2017; \u003cstrong\u003e26\u003c/strong\u003e(5): 360-71.\u003c/li\u003e\n\u003cli\u003eCowling TE, Majeed A, Harris MJ. Importance of accessibility and opening hours to overall patient experience of general practice: analysis of repeated cross-sectional data from a national patient survey. \u003cem\u003eThe British journal of general practice : the journal of the Royal College of General Practitioners\u003c/em\u003e 2018; \u003cstrong\u003e68\u003c/strong\u003e(672): e469-e77.\u003c/li\u003e\n\u003cli\u003eCowling TE, Majeed A, Harris MJ. Patient experience of general practice and use of emergency hospital services in England: regression analysis of national cross-sectional time series data. \u003cem\u003eBMJ quality \u0026amp; safety\u003c/em\u003e 2018; \u003cstrong\u003e27\u003c/strong\u003e(8): 643-54.\u003c/li\u003e\n\u003cli\u003eHu G, Chen Y, Liu Q, et al. Patient experience of hospital care in China: major findings from the Chinese Patient Experience Questionnaire Survey (2016-2018). \u003cem\u003eBMJ open\u003c/em\u003e 2019; \u003cstrong\u003e9\u003c/strong\u003e(9): e031615.\u003c/li\u003e\n\u003cli\u003eSenn N, Cohidon C, Breton M, Levesque JF, Zuchuat JC. Patterns of patient experience with primary care access in Australia, Canada, New Zealand and Switzerland: a comparative study. \u003cem\u003eInternational journal for quality in health care : journal of the International Society for Quality in Health Care / ISQua\u003c/em\u003e 2019; \u003cstrong\u003e31\u003c/strong\u003e(9): G126-G32.\u003c/li\u003e\n\u003cli\u003eTalbo MK, Katz A, Dostie M, Legault L, Brazeau AS. Associations Between Socioeconomic Status and Patient Experience With Type 1 Diabetes Management and Complications: Cross-sectional Analysis of a Cohort From Quebec, Canada. \u003cem\u003eCanadian journal of diabetes\u003c/em\u003e 2022.\u003c/li\u003e\n\u003cli\u003eOECD. OECD Health Statistics. Paris: OECD Publishing; 2023.\u003c/li\u003e\n\u003cli\u003eDyer O. South Korea: Striking junior doctors are threatened with arrest and suspension. \u003cem\u003eBmj\u003c/em\u003e 2024; \u003cstrong\u003e384\u003c/strong\u003e: q495.\u003c/li\u003e\n\u003cli\u003eNHS. Overall Patient Experience Scores. London: NHS England, 2020.\u003c/li\u003e\n\u003cli\u003eHoneyford K, Greaves F, Aylin P, Bottle A. Secondary analysis of hospital patient experience scores across England\u0026apos;s National Health Service - How much has improved since 2005? \u003cem\u003ePloS one\u003c/em\u003e 2017; \u003cstrong\u003e12\u003c/strong\u003e(10): e0187012.\u003c/li\u003e\n\u003cli\u003eEngland N. Overall Patient Experience Scores: 2018 Adult Inpatient Survey update. 2019.\u003c/li\u003e\n\u003cli\u003eJha AK, Orav EJ, Zheng J, Epstein AM. Patients\u0026apos; perception of hospital care in the United States. \u003cem\u003eThe New England journal of medicine\u003c/em\u003e 2008; \u003cstrong\u003e359\u003c/strong\u003e(18): 1921-31.\u003c/li\u003e\n\u003cli\u003eDavidson MJ, Lacroix J, McMartin S, Kudhail R, Hart K, Diestelkamp N. Patient Experiencces in Canadian Hospitals. \u003cem\u003eHealthcare Quartely\u003c/em\u003e 2019; \u003cstrong\u003e22\u003c/strong\u003e(3): 12-4.\u003c/li\u003e\n\u003cli\u003eCowling TE, Laverty AA, Harris MJ, Watt HC, Greaves F, Majeed A. Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey. \u003cem\u003eJournal of the Royal Society of Medicine\u003c/em\u003e 2017; \u003cstrong\u003e110\u003c/strong\u003e(11): 440-51.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"patient experience, hospital care, national survey, health policy, South Korea","lastPublishedDoi":"10.21203/rs.3.rs-7106896/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7106896/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eObjective\u003c/h2\u003e\u003cp\u003eTo evaluate hospital care quality from patients' perspectives and identify individual and institutional factors influencing patients\u0026rsquo; experiences, with policy implications for hospital workforce planning in South Korea. Study Design: Cross-sectional study\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eWe analyzed data from the Korean National Patient Experience Survey (KNPES) administered in 2017, 2019, and 2021, targeting patients aged\u0026thinsp;\u0026ge;\u0026thinsp;20 years discharged from 601 hospitals. The 24-item survey assessed five domains: physicians, nurses, treatment process, hospital environment, and patient rights. Composite scores were computed. Multiple regression analysis identified demographic and institutional predictors.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eResponses were obtained from 14,970 (2017), 23,924 (2019), and 58,258 (2021) patients (mean age: 56.3\u0026thinsp;\u0026plusmn;\u0026thinsp;15.3 years; 50.2% male). The overall composite score was 83.94\u0026thinsp;\u0026plusmn;\u0026thinsp;15.98. Nurse communication consistently received the highest ratings, while patient rights received the lowest. Factors significantly associated with higher patient experience scores included younger age, higher education, Medical Aid enrollment, treatment in internal medicine, secondary hospital status, and higher nurse staffing levels.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eNurse staffing levels exhibited the strongest association with positive patient experiences. These findings underscore the importance of nurse workforce policies in improving care quality and patient-centered outcomes.\u003c/p\u003e","manuscriptTitle":"Patient Experiences of Hospital Care in South Korea in Three Biennial National Surveys from 2017 to 2021 Running Title: Patient Experiences in Korea","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-22 10:28:16","doi":"10.21203/rs.3.rs-7106896/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-09-04T21:00:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"300179751331537444477749401808350642575","date":"2025-08-25T13:00:10+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-14T14:54:32+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-13T06:21:20+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-28T12:24:57+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-28T09:45:25+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Health Services Research","date":"2025-07-28T09:41:12+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-health-services-research","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bhsr","sideBox":"Learn more about [BMC Health Services Research](http://bmchealthservres.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/BHSR/default.aspx","title":"BMC Health Services Research","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2192713a-567e-40ee-80ad-5f2beb040d70","owner":[],"postedDate":"August 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-08-22T10:28:16+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-22 10:28:16","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7106896","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7106896","identity":"rs-7106896","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}