Patient Satisfaction and its Influencing Factors:  Results from a survey in inpatient department in a tertiary hospital setting in China

Patient Satisfaction and its Influencing Factors: Results from a survey in inpatient department in a tertiary hospital setting in China | 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 Article Patient Satisfaction and its Influencing Factors: Results from a survey in inpatient department in a tertiary hospital setting in China Cairu Xu, Xinpeng Xu, Yanfang Su, Jiansong Ji This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7055229/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Patient satisfaction constitutes one of the three dimensions of health system performance metrics, alongside health status and financial protection. Nevertheless, comprehension of the elements influencing patient satisfaction remains limited. This study aims to evaluate inpatient satisfaction through a survey. We conducted a survey of 433 patients at the Fifth Hospital Affiliated with Wenzhou Medical University using a stratified random sampling technique to provide scientific evidence for enhancing inpatient satisfaction. The Kruskal-Wallis test and ordered logistic regression were utilized to examine the relationship between inpatient satisfaction and its influencing factors. The results indicated that the average inpatient satisfaction score was 4.49, with higher scores for medical process and medical technology, and the lowest score for medical cost. Univariate analysis revealed a significant association between payment methods and overall satisfaction. Ordered logistic regression indicated that inpatient satisfaction increased with higher scores in all dimensions of healthcare service quality. Medical technology, doctor-patient communication, environmental factors, medical processes, and medical costs significantly and positively influence inpatient satisfaction. The overall satisfaction with inpatient services is affected by multiple factors, and enhancements can be achieved by optimizing doctor-patient communication, improving the hospital environment and facilities, and standardizing the medical service process. Health sciences/Health care Health sciences/Health occupations Health sciences/Medical research satisfaction ordered logistic regression inpatients influencing factors Introduction Inpatient satisfaction is a fundamental metric of healthcare service quality. Given the ongoing emphasis on service quality and patient experience within healthcare, patient satisfaction is a critical outcome measure of healthcare quality, directly influencing the frequency of medical disputes and hospital reputation. In recent years, the examination of inpatient satisfaction has emerged as a pivotal concern in healthcare quality improvement in the United States, the United Kingdom, Japan, and other countries 1 . International research on patient satisfaction has been conducted before, with the majority of studies employing standardized instruments and multivariate analysis 2 , 3 , 4 , 5 . The United States has prioritized healthcare quality research since the 1960s, establishing a national patient evaluation system through Agency for Healthcare Research and Quality in 1997, and introducing Hospital Consumer Assessment of Healthcare Providers and Systems in 2008 as a fundamental instrument for national healthcare management 6 ; In 2002, the National Health Service Commissioning Board for Healthcare Quality in England conducted a patient satisfaction survey encompassing emergency, mental health, maternal and child health, and general practitioner services, subsequently relaying the findings to pertinent organizations to enhance healthcare services 7 . Consequently, relevant organizations in Japan, Korea, and other countries have initiated nationwide surveys regarding hospitalized patients' satisfaction 8 . Chinese inpatient satisfaction research commenced in the late 1980s, initially characterized by a scarcity of measurement tools. Despite the proliferation of patient satisfaction surveys across various regions and hospitals in China, there remains an absence of standardized and unified questionnaires and evaluation systems. In the 21st century, the emergence of the patient experience concept has led to a gradual integration of satisfaction and experience assessments, with scale design increasingly emphasizing patient involvement and multifaceted service requirements 9 , 10 , 11 . For example, some study pointed out that with limited medical resources, hospitals could improve the quality of medical services by optimizing spatial distribution 12 . The Service Quality theory proposed by A. Parasuraman et al. delineates five dimensions of service quality that influence satisfaction: physical amenities, reliability, responsiveness, security, and emotional engagement 13 . Zhu and Ma asserted that satisfaction encompassed not only the comprehensiveness, safety, timeliness, and effectiveness of diagnosis and treatment, but also the quality dimensions inherent in the entire continuum of medical services rendered by healthcare professionals to patients 14 . The primary determinants of hospitalized patients' satisfaction are the professional and technical competencies of medical personnel, doctor-patient communication, the hospital environment, and other facets of medical service delivery, while the impact of patients' individual needs is comparatively minimal. Furthermore, while there is a lack of definitive literature illustrating that patient sociodemographic characteristics influence inpatient satisfaction, several studies have confirmed that such characteristics (e.g., age, gender, education level, income) do affect inpatient satisfaction, although the precise impact may differ based on the study population, region, and cultural context 15 , 16 . Materials and Methods Survey design Unlike previous studies, the questionnaire in this research was developed based on three theoretical frameworks: Maslow's hierarchy of needs theory 17 , the three-dimensional quality structure model 18 , and Service Quality theory, utilizing the national tertiary public hospital performance appraisal satisfaction score. In designing the questionnaire, we acknowledged the cultural differences between China and Western countries and integrated the opinions of experts from both domestic and international sources to formulate a scientifically valid questionnaire tailored to the target population. In addition, recognizing the challenges faced by elderly respondents in independently completing electronic questionnaires, the investigator verbally elucidates the topic and clarifies the questionnaire content for the respondents to facilitate the completion survey process. Data source This study recruited inpatients from the Fifth Affiliated Hospital of Wenzhou Medical University from October to November 2024. We employed stratified random sampling to classify wards into 48 distinctive functional strata (e.g., internal medicine, surgery, orthopedics, obstetrics/gynecology). Ten hospitalized patients were randomly selected from each stratum, yielding 480 surveys participants. The inclusion criteria for the satisfaction survey were: (1) a hospitalization length of three days or more; and (2) provision of informed consent. For inpatients who are incapable of independently completing questionnaires due to impaired consciousness, cognitive dysfunction, mobility limitations, or self-care disabilities, proxies, such as nurses or family caregivers facilitated the completion of the questionnaires. The questionnaire was prepared in accordance with China's National Public Hospital Performance Evaluation Indicators 19 . An anonymous survey methodology was utilized to safeguard patient anonymity, minimize potential bias from external factors throughout the survey. The scale consists of two main elements: the socio-demographic characteristics of respondents and satisfaction metrics. The collected socio-demographic characteristics comprised of: (1) gender, (2) age, (3) educational attainment, (4) monthly income, (5) occupation, and (6) payment methods. The satisfaction survey evaluated five dimensions: (1) medical technology, (2) physician-patient communication, (3) environment, (4) clinical processes, and (5) healthcare costs. Data collection was conducted and administered electronically using the Questionnaire Star platform. Satisfaction levels across all dimensions and overall satisfaction are measured using a five-point Likert scale 21 , with options including “very dissatisfied,” “somewhat dissatisfied,” “neutral,” “somewhat satisfied,” and “very satisfied.” Each option is assigned a score from 1 to 5, with 1 representing the lowest satisfaction level and 5 representing the highest satisfaction level. The scores for all items within a given dimension are summed, and the arithmetic mean is calculated. A higher score indicates higher satisfaction within that dimension. Statistical methods Reliability analysis evaluates the internal consistency and stability of a measurement scale, determining whether all items consistently measure the same underlying construct.Validity analysis examines the extent to which a scale accurately measures the intended theoretical construct, including verification of its dimensional structure against hypothesized models.Correlation analysis quantifies the strength and direction of a monotonic association between two variables. Data cleaning procedures involved: (1) retaining only the most recent submission for duplicate questionnaires identified by the same mobile phone number or WeChat ID, (2) removing questionnaires exhibiting illogical response times, (3) removing questionnaires exhibiting illogical response patterns. Statistical analyses were performed utilizing SPSS 27.0. The level of satisfaction among respondents was characterized using descriptive statistics, including means with standard deviations for continuous variables and percentages for categorical variables. Reliability of the scale was assessed using Cronbach's alpha coefficient (α), while structural validity was evaluated through the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's test of sphericity.; A correlational analysis was conducted to investigate the relationships between the different dimensions of satisfaction and overall satisfaction 22 . Due to the non-normal distribution of satisfaction scores, three or more independent samples were analyzed using the Kruskal-Wallis H test for one-way analysis of socio-demographic characteristics, while two independent samples were analyzed with the Mann-Whitney U test for one-way analysis of significance, with a significance level of p < 0.05.Given that linear regression requires continuous variables and the dependent variable was an ordinal categorical variable, multivariate analyses were conducted using an ordered logistic regression model to identify determinants of patient satisfaction. Measurements are presented as mean ± standard deviation (mean ± SD), and categorical data are conveyed as frequencies and percentages. Results Characteristics of the study sample We collected data from 480 patients. After data cleansing, 433 valid survey responses were kept for data analysis, resulting in an effective recovery rate of 90.2%. Among the surveyed inpatient patients, 239 (55.2%) were female. Female patients exhibited marginally lower satisfaction scores than their male counterparts. Individuals over 60 years accounted for the largest proportion (34.4%), followed by those aged 50–59 years at 20.8%. The percentage of patients under 20 years old was the lowest at 1.4%, although their satisfaction level was the greatest across all age groups. The proportion of patients with a middle school education or lower was the highest at 54.1%, whereas those with a master’s degree or more constituted the smallest group. Patients possessing a bachelor’s degree or higher exhibited the greatest levels of hospital satisfaction. The predominant income bracket was between 4,001 Yuan and 6,000 Yuan, whereas both high- and low-income groups were considerably smaller. Farmers compromised the largest segment of the occupational groups at 39.7%, whereas students constituted the smallest fraction at 2.8%. Concerning payment options, 82% of patients utilized urban and rural residents' medical insurance, while the other patients relied on out-of-pocket payments or free medical service. The analysis indicates that no statistically significant differences were found in overall satisfaction across subgroups stratified by patients' gender, age, educational attainment, monthly income, and occupation. However, a statistically significant association was identified between payment methods and satisfaction levels (Table 1 ). Table 1 Summary statistics of hospitalized patients and results of Mann-Whitney U/Kruskal-Wallis H tests Basic Information Groups n (%) Satisfaction Score (Mean ± SD) Z/H Score P- value Sex -0.935 0.350 Male 194(44.8) 4.54 ± 0.846 Female 239(55.2) 4.46 ± 0.887 Age(years) 2.182 0.702 ≤ 20 6(1.4) 4.83 ± 0.408 20–29 50(11.5) 4.58 ± 0.758 30–39 60(13.9) 4.32 ± 1.066 40–49 78(18.0) 4.42 ± 0.947 50–59 90(20.8) 4.59 ± 0.748 ≥ 60 149(34.4) 4.50 ± 0.851 Education Level 4.667 0.323 Middle school or below 237(54.1) 4.51 ± 0.826 High school or secondary school 90(20.8) 4.34 ± 0.996 Bachelor's degree or college diploma 99(22.9) 4.62 ± 0.765 Master's degree or higher 7(1.6) 4.00 ± 1.528 monthly income(yuan) 6.342 0.175 ≤ 2000 86(19.9) 4.59 ± 0.709 2001—4000 109(25.2) 4.53 ± 0.845 4001—6000 119(27.5) 4.51 ± 0.862 6001—8000 58(13.4) 4.47 ± 0.941 ≥ 8001 61(14.1) 4.28 ± 1.035 Occupation 2.277 0.685 Students 12(2.8) 4.67 ± 0.651 Corporate/ institutional employees 58(13.4) 4.53 ± 0.863 Workers 45(10.4) 4.60 ± 0.863 Self-employed individuals 77(17.8) 4.29 ± 0.985 Farmers 172(39.7) 4.47 ± 0.881 Others 69(15.9) 4.65 ± 0.703 Payment Methods 10.866 0.028 Out-of-pocket 31(7.2) 4.23 ± 1.146 Basic health insurance 355(82.0) 4.50 ± 0.865 Free medical service 47(10.9) 4.66 ± 0.635 Note. Between-group comparisons were performed utilizing the Mann-Whitney U test for analyses involving two groups and the Kruskal-Wallis H test for three or more independent samples. Reliability and Exploratory Factor Analysis The reliability and validity of the questionnaire was evaluated using Cronbach’s α coefficient and the Kaiser-Meyer-Olkin (KMO) measure. The Cronbach’s α values for the individual dimensions were 0.893, 0.872, 0.901, 0.874, and 0.850, respectively, with an overall α of 0.949, demonstrating strong reliability. The questionnaire data underwent exploratory factor analysis, yielding a KMO score of 0.935 and a significant Bartlett's test of sphericity (χ² = 6838.470, p < 0.001), indicating the appropriateness for factor analysis. Correlation Analysis of Hospitalized Patients' Satisfaction Due to the variables' nonconformity to normal distribution, Spearman's rank correlation analysis was conducted, which revealing a significant positive correlation between overall patient satisfaction and all dimensions of healthcare service quality (p < 0.01). The results of correlation analysis are shown in Table 2 . Table 2 Spearman Correlation Analysis of Patient Satisfaction Dimensions Dimension Medical Technology Patient-Doctor Communication Environmental Medical Process Medical Expenses Overall satisfaction 0.516** 0.589** 0.622** 0.465** 0.597** Note. p < 0.01 (two-tailed). Correlation coefficients were calculated using Spearman's ρ. Factors associated with patient satisfaction The variables included in the model were diagnosed for covariance, revealing tolerances exceeding 0.1 and variance inflation factors below 5, with no multicollinearity between the respective variables; the parallel lines test yielded a p-value of 0.406, surpassing the 0.05 threshold, thereby confirming that the model satisfies the assumption of parallel lines and is suitable for analysis via ordered logistic regression. The independent variables comprise medical technology, doctor-patient communication, environment, medical processes, and medical costs, while the dependent variable is the overall satisfaction. The estimated results revealed that satisfaction with medical technology, doctor-patient communication, environment, medical processes, and medical costs are the main factors affecting inpatient satisfaction and have a significant effect on inpatient satisfaction. The regression results are shown in Table 3 . Table 3 Logistic Regression Analysis of Factors associated with Inpatient Satisfaction Factor β OR P Satisfaction Score (mean ± SD) Tolerance VIF Medical Technology 0.554 1.771 0.010 4.37 ± 0.761 0.451 2.220 Patient-Doctor Communication 0.947 2.495 0.000 4.17 ± 0.815 0.389 2.568 Environmental Logistics 1.065 2.859 0.000 4.11 ± 0.841 0.465 2.151 Medical Process 0.542 1.734 0.005 4.35 ± 0.726 0.619 1.615 Medical Expenses 0.681 2.043 0.000 4.04 ± 0.911 0.522 1.915 Parallel-line test ( p ) — — 0.406 — — — Note. β = standardized coefficient; OR = odds ratio; VIF = variance inflation factor. All p -values are two-tailed. The survey revealed that the average satisfaction score of inpatients at Wenzhou Medical University Fifth Affiliated Hospital was 4.49 ± 0.869, resulting in an overall satisfaction rate of 86.6%. The five dimensions of satisfaction including medical technology (OR = 1.740, P = 0.010), doctor-patient communication (OR = 2.495, P < 0.001), environmental factors (OR = 2.902, P < 0.001), medical processes (OR = 1.720,P = 0.005), and medical costs (OR = 1.975, P < 0.001) significantly influence inpatient satisfaction. Discussion The research indicated that there is a significant correlation between payment methods and overall satisfaction.Medical technology, doctor-patient communication, environmental factors, medical processes, and medical costs significantly and positively influence inpatient satisfaction. Inpatient satisfaction in the Fifth Affiliated Hospital of Wenzhou Medical University aligns with the general satisfaction levels at domestic public tertiary hospitals. Yet, there remains potential for enhancement when compared to medical institutions that exhibit superior satisfaction rates. For example, hospitals in eastern regions typically exhibit higher satisfaction levels compared to those in central and western regions 23 , 24 . This study indicated that patients' expectations and perceptions of medical services are independent of gender, age, education level, monthly income, or occupation, yet a statistically significant difference exists concerning the method of payment for hospitalization expenses. Additionally, medical costs, doctor-patient communication, environment, medical procedures, and medical technology significantly impact inpatient satisfaction. From a broad view, the differences in inpatient satisfaction levels between domestic and overseas hospitals mostly arises from variations in healthcare systems and cultural expectations 25 , 26 , 27 . Furthermore, variations in hospital management tiers and patient sociodemographic attributes contribute to notable disparities in satisfaction levels. From a micro perspective, the efficacy of communication between doctors and nurses in medical services, along with the precision of hospital treatment protocols, are pivotal factors; regarding the hospital environment, factors such as ward conditions and meal quality also affect patient satisfaction; the affordability of medical costs and the accessibility of medical procedures are also significant considerations 28 , 29 . These factors are highly consistent with the findings of this study. Cultural values significantly impact patient satisfaction during hospitalization 30 . The score for the doctor-patient communication dimension in this survey was 4.17 ± 0.815. Effective medical communication can cultivate trust among doctors, nurses, and patients 31 , facilitating positive interactions and information exchange between healthcare professionals and patients. In clinical practice, patients often exhibit anxiety, concern, and discomfort during hospital visits, stemming from the unpredictability of disease progression and prognosis 32 . Currently, communication skills in diagnosis, treatment, and nursing are of paramount importance. Unprofessional conduct or disregard for patients' emotions may diminish their faith in healthcare providers and can incite confrontations between physicians and patients. An optimal hospital environment is essential for safeguarding the physical and mental health of patients, with environmental services serving as a critical indicator of hospital management quality. Environmental services encompass hospital hygiene and cleanliness, signage clarity, nutritional quality and palatability of cafeteria meals, and the adequacy of service facilities. Hospitals need to strengthen environmental management and planning to provide patients with a better medical experience. A high score in medical procedure dimension indicates that the hospital has well-structured medical protocols that efficiently navigate patients through each stage of the process, including registration, diagnosis, examination, treatment, and medication pickup. The discharge and admission procedures are streamlined, minimizing superfluous waiting and travel time for patients and their families. The hospital provides clear medical guidance to patients, encompassing diagnostic procedures, examination components, and medication instructions, facilitating a seamless medical experience. The medical procedure dimension reflects the hospital's present service quality and highlights opportunities for future enhancement and advancement. By persistently refining medical procedures, enhancing service efficiency, and improving patient experience, the hospital may maintain its competitive advantage in the fiercely contested healthcare industry and cultivate consumers' confidence and loyalty. This study revealed a medical technology satisfaction score of 4.35 ± 0.726, the highest among all dimensions, suggesting the pivotal significance of medical technology in the overall quality of hospital services. Medical technology includes a wide range of elements, comprising innovative medical devices, professional expertise, clinical experience, and the collaborative capacities of healthcare professionals. These components interconnect to create an integrated medical technology system. The expertise and proficiency of physicians, the complexity of hospital pain management protocols, and the precision and lucidity of treatment regimens significantly influence patient satisfaction. Medical expenses received the lowest rating across all dimensions. Patients prioritize the transparency of medical charges, the fairness of drug and examination fees, and the clarity of the cost breakdown when seeking medical care. These elements directly or indirectly affect patients' comprehensive assessment and satisfaction with hospital treatment. This study has several implications. Hospitals should prioritize the establishment of a patient-centered service system 33 , enhance training in service concepts for medical personnel, integrate fundamental medical knowledge with friendly service skills 34 , and consistently elevate professional competence and service standards. Hospitals also should enhance patient feedback mechanisms by instituting suggestion boxes, launching service hotlines, and creating online evaluation platforms to collect patient opinions through multiple channels, as well as implementing a rapid response mechanism to promptly analyze and adopt feasible recommendations from patients and continually refine service processes, to deliver superior, more personalized medical care. In terms of the medical environment, it is imperative to prioritize improving the quality of patient room environments. This can be achieved by enhancing lighting and ventilation conditions, strengthening hygiene and cleaning management, and implementing infection control measures to meaningfully enhance patients' hospital stay experience 35 . Emphasis should also be placed on the quality of dietary services, offering diverse and nutritionally balanced meal alternatives to accommodate the dietary requirements of different patients 36 , 37 . Additionally, the hospital's signage system requires enhancement to provide clear and succinct directional instructions, allowing patients and their families to quickly locate target areas. A well-thought-out spatial layout and robust infrastructure maintenance are crucial for creating a safe, comfortable, and convenient medical environment for patients. In addition to these foundational steps, hospitals can significantly improve triage efficiency by implementing an intelligent admission system 38 that integrates appointment scheduling, registration processes, and payment functions through advanced medical information technology. Investing in self-service kiosks is another key move, enabling a shift from reactive assistance to anticipatory service delivery 39 and thereby streamlining patient workflows. Furthermore, hospitals should prioritize the acquisition of advanced medical technologies to enhance diagnostic accuracy and therapeutic efficacy. This should be accompanied by the establishment of comprehensive training programs to ensure that medical staff are proficient in applying these emerging technologies 40 , which will ultimately enhance patient care experiences. To ensure financial transparency, hospitals must implement real-time cost tracking systems through verified digital channels, providing patients with immediate access to detailed treatment expenditures 41 . Standardized physician-patient communication protocols should also be established, requiring clinicians to comprehensively explain both the clinical rationale for medications and their associated costs during prescription. To further bolster patients' understanding of medical reimbursement policies 42 , hospitals should establish dedicated insurance consultation counters and conduct professional education programs. Lastly, collaborating with social welfare organizations to set up medical assistance funds can offer much-needed financial support and fee reductions for economically disadvantaged patients. There are also limitations worth noting. First, the study sample primarily originated from a specific region and a hospital, potentially limiting its representativeness and influencing the generalizability of the findings to other regions, healthcare facilities, and heterogeneous populations. Second, the study employed a cross-sectional design without longitudinal follow-up data, making it difficult to elucidate the dynamic patterns of patient satisfaction over time. Third, the study methodology exclusively utilized quantitative analysis, and did not incorporate qualitative research to explore patient experiences in depth, which may have overlooked other factors related to patient experience. Finally, the study did not conduct specific analyses for patients from different cultural backgrounds, which may affect the cross-cultural applicability of the conclusions. Conclusion Patient satisfaction during hospitalization is one of the key indicators for assessing the quality of healthcare services, directly impacting public fulfillment and happiness. Understanding and improving patient satisfaction is of great significance for advancing the quality of healthcare institutions. This study is based on questionnaire survey data collected from inpatients at the Fifth Affiliated Hospital of Wenzhou Medical University between October and November 2024. Descriptive statistical analysis, rank sum tests, and ordered logistic regression methods were used to explore the key factors affecting inpatient satisfaction. The study found that patient satisfaction during hospitalization is influenced by six key factors: doctor-patient communication, medical technology, hospital environment, medical processes, and medical costs. It is important to note that the specific manifestations of these influencing factors may vary depending on the characteristics of the study population, regional differences, and cultural backgrounds. Healthcare facilities should concentrate on these pivotal influencing aspects to create focused quality improvement programs, to methodically elevate the quality of healthcare services and patient satisfaction. Declarations Competing interests The authors declare no competing interests. Human Subject Research Approval This study was reviewed and approved by Internal Review Board at ID:2024(Ⅰ)-067-01. Author Contribution CX and JJ conceived the idea. JJ and YS supervised the work. CX performed data collection, conducted statistical analysis, and drafted the first version of the manuscript. CX, YS, and XX participated in manuscript revision and critical editing. All authors contributed to the interpretation of results, revisions, and final approval of the paper. Acknowledgement This study was supported by the Fifth Affiliated Hospital of Wenzhou Medical University. No funding was available for this study.We thank Luyanda Z Ngongoma, Jerry Song, and Ella Shi for valuable comments and edits. Data Availability The de-identified datasets are available upon request. References Ferreira, D. C. et al. Patient satisfaction with healthcare services and the techniques used for its assessment: a systematic literature review and a bibliometric analysis. Healthc. (Basel) 11 , 639 (2023). Zusman, E.E. HCAHPS replaces Press Ganey survey as quality measure for patient hospital experience. Neurosurgery 71 , 21-24 (2012). Jenkinson, C., Coulter, A. & Bruster, S. Patients' experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care. Qual. Saf. Health Care 11 , 335-339 (2002). Crispin, J., Angela, C. & Stephen, B. 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A study on patients' satisfaction with the admission process and improvement points in a hospital. Chin. Health Care Manag. 35 , 652–656 (2018). Ma, Q. How to build a high-quality healthcare talent pipeline. Hum. Resour. 8 , 115-117 (2024). Wang, J. & Zhai, S. The realization and effectiveness of full disclosure of medical expenses. J. Hosp. Manag. People's Liber. Army 1 , 76-77 (2002). Tan, F. & Mo, C. The needs and effects of health insurance policy propaganda in hospital management. Armed Police Med. 27 , 636-638 (2016). Additional Declarations No competing interests reported. Supplementary Files data.xlsx Cite Share Download PDF Status: Posted Version 1 posted 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. 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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-7055229","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":485152267,"identity":"faa7d0ef-f6bd-45e0-a46d-5f6f08ea692c","order_by":0,"name":"Cairu Xu","email":"","orcid":"","institution":"Wenzhou Medical University Ningbo Campus","correspondingAuthor":false,"prefix":"","firstName":"Cairu","middleName":"","lastName":"Xu","suffix":""},{"id":485152268,"identity":"1ac1508c-1e6d-4d65-a7e9-297ee255cd5f","order_by":1,"name":"Xinpeng Xu","email":"","orcid":"","institution":"Nanjing Medical University","correspondingAuthor":false,"prefix":"","firstName":"Xinpeng","middleName":"","lastName":"Xu","suffix":""},{"id":485152269,"identity":"273aad79-bbd5-4456-b15c-cb2f7a57e3e0","order_by":2,"name":"Yanfang Su","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAlElEQVRIiWNgGAWjYDAC5gMMDB/ArARitbAlMDDOIFkLMw9JWgyOsT+Ttm07zMDPnmNArBYeM+lcoBbJnjfEarnfwwbUcpvB4AbxtgAdZgnUYk+CFgYzaUaQLRLEapE8xmNs2XPuP4/EmWcFxGnhO8b+8MaPsjQ5/vbkDcRpUTgAoXmIUw4C8g3Eqx0Fo2AUjIKRCgDQbCj+0bYhwgAAAABJRU5ErkJggg==","orcid":"","institution":"University of Washington","correspondingAuthor":true,"prefix":"","firstName":"Yanfang","middleName":"","lastName":"Su","suffix":""},{"id":485152270,"identity":"d430e852-ee2a-4011-bfe6-fad32536fbc1","order_by":3,"name":"Jiansong Ji","email":"","orcid":"","institution":"Wenzhou Medical University","correspondingAuthor":false,"prefix":"","firstName":"Jiansong","middleName":"","lastName":"Ji","suffix":""}],"badges":[],"createdAt":"2025-07-06 00:38:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7055229/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7055229/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93043557,"identity":"2bc5747b-b046-41ca-b235-6e66bac34001","added_by":"auto","created_at":"2025-10-08 12:47:04","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":738087,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7055229/v1/8ad9efd5-6105-47e7-a9b1-21de07dc211a.pdf"},{"id":86933829,"identity":"20dfb149-2476-4a56-be35-ab059af36d85","added_by":"auto","created_at":"2025-07-17 10:18:06","extension":"xlsx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":79417,"visible":true,"origin":"","legend":"","description":"","filename":"data.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-7055229/v1/0dcd87999a9d6dffbeb42814.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Patient Satisfaction and its Influencing Factors: Results from a survey in inpatient department in a tertiary hospital setting in China ","fulltext":[{"header":"Introduction","content":"\u003cp\u003eInpatient satisfaction is a fundamental metric of healthcare service quality. Given the ongoing emphasis on service quality and patient experience within healthcare, patient satisfaction is a critical outcome measure of healthcare quality, directly influencing the frequency of medical disputes and hospital reputation. In recent years, the examination of inpatient satisfaction has emerged as a pivotal concern in healthcare quality improvement in the United States, the United Kingdom, Japan, and other countries\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eInternational research on patient satisfaction has been conducted before, with the majority of studies employing standardized instruments and multivariate analysis\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e. The United States has prioritized healthcare quality research since the 1960s, establishing a national patient evaluation system through Agency for Healthcare Research and Quality in 1997, and introducing Hospital Consumer Assessment of Healthcare Providers and Systems in 2008 as a fundamental instrument for national healthcare management\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e; In 2002, the National Health Service Commissioning Board for Healthcare Quality in England conducted a patient satisfaction survey encompassing emergency, mental health, maternal and child health, and general practitioner services, subsequently relaying the findings to pertinent organizations to enhance healthcare services\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e. Consequently, relevant organizations in Japan, Korea, and other countries have initiated nationwide surveys regarding hospitalized patients' satisfaction\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e\u003c/sup\u003e. Chinese inpatient satisfaction research commenced in the late 1980s, initially characterized by a scarcity of measurement tools. Despite the proliferation of patient satisfaction surveys across various regions and hospitals in China, there remains an absence of standardized and unified questionnaires and evaluation systems. In the 21st century, the emergence of the patient experience concept has led to a gradual integration of satisfaction and experience assessments, with scale design increasingly emphasizing patient involvement and multifaceted service requirements\u003csup\u003e\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e,\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u003c/sup\u003e. For example, some study pointed out that with limited medical resources, hospitals could improve the quality of medical services by optimizing spatial distribution \u003csup\u003e\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e\u003c/sup\u003e. The Service Quality theory proposed by A. Parasuraman et al. delineates five dimensions of service quality that influence satisfaction: physical amenities, reliability, responsiveness, security, and emotional engagement\u003csup\u003e\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e\u003c/sup\u003e. Zhu and Ma asserted that satisfaction encompassed not only the comprehensiveness, safety, timeliness, and effectiveness of diagnosis and treatment, but also the quality dimensions inherent in the entire continuum of medical services rendered by healthcare professionals to patients\u003csup\u003e\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e\u003c/sup\u003e. The primary determinants of hospitalized patients' satisfaction are the professional and technical competencies of medical personnel, doctor-patient communication, the hospital environment, and other facets of medical service delivery, while the impact of patients' individual needs is comparatively minimal. Furthermore, while there is a lack of definitive literature illustrating that patient sociodemographic characteristics influence inpatient satisfaction, several studies have confirmed that such characteristics (e.g., age, gender, education level, income) do affect inpatient satisfaction, although the precise impact may differ based on the study population, region, and cultural context\u003csup\u003e\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e,\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u003c/sup\u003e.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eSurvey design\u003c/p\u003e\u003cp\u003eUnlike previous studies, the questionnaire in this research was developed based on three theoretical frameworks: Maslow's hierarchy of needs theory\u003csup\u003e\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e\u003c/sup\u003e, the three-dimensional quality structure model\u003csup\u003e\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u003c/sup\u003e, and Service Quality theory, utilizing the national tertiary public hospital performance appraisal satisfaction score. In designing the questionnaire, we acknowledged the cultural differences between China and Western countries and integrated the opinions of experts from both domestic and international sources to formulate a scientifically valid questionnaire tailored to the target population. In addition, recognizing the challenges faced by elderly respondents in independently completing electronic questionnaires, the investigator verbally elucidates the topic and clarifies the questionnaire content for the respondents to facilitate the completion survey process.\u003c/p\u003e\u003cp\u003eData source\u003c/p\u003e\u003cp\u003eThis study recruited inpatients from the Fifth Affiliated Hospital of Wenzhou Medical University from October to November 2024. We employed stratified random sampling to classify wards into 48 distinctive functional strata (e.g., internal medicine, surgery, orthopedics, obstetrics/gynecology). Ten hospitalized patients were randomly selected from each stratum, yielding 480 surveys participants. The inclusion criteria for the satisfaction survey were: (1) a hospitalization length of three days or more; and (2) provision of informed consent. For inpatients who are incapable of independently completing questionnaires due to impaired consciousness, cognitive dysfunction, mobility limitations, or self-care disabilities, proxies, such as nurses or family caregivers facilitated the completion of the questionnaires. The questionnaire was prepared in accordance with China's National Public Hospital Performance Evaluation Indicators\u003csup\u003e\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u003c/sup\u003e. An anonymous survey methodology was utilized to safeguard patient anonymity, minimize potential bias from external factors throughout the survey. The scale consists of two main elements: the socio-demographic characteristics of respondents and satisfaction metrics. The collected socio-demographic characteristics comprised of: (1) gender, (2) age, (3) educational attainment, (4) monthly income, (5) occupation, and (6) payment methods. The satisfaction survey evaluated five dimensions: (1) medical technology, (2) physician-patient communication, (3) environment, (4) clinical processes, and (5) healthcare costs. Data collection was conducted and administered electronically using the Questionnaire Star platform. Satisfaction levels across all dimensions and overall satisfaction are measured using a five-point Likert scale\u003csup\u003e\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u003c/sup\u003e, with options including \u0026ldquo;very dissatisfied,\u0026rdquo; \u0026ldquo;somewhat dissatisfied,\u0026rdquo; \u0026ldquo;neutral,\u0026rdquo; \u0026ldquo;somewhat satisfied,\u0026rdquo; and \u0026ldquo;very satisfied.\u0026rdquo; Each option is assigned a score from 1 to 5, with 1 representing the lowest satisfaction level and 5 representing the highest satisfaction level. The scores for all items within a given dimension are summed, and the arithmetic mean is calculated. A higher score indicates higher satisfaction within that dimension.\u003c/p\u003e\u003cp\u003eStatistical methods\u003c/p\u003e\u003cp\u003eReliability analysis evaluates the internal consistency and stability of a measurement scale, determining whether all items consistently measure the same underlying construct.Validity analysis examines the extent to which a scale accurately measures the intended theoretical construct, including verification of its dimensional structure against hypothesized models.Correlation analysis quantifies the strength and direction of a monotonic association between two variables. Data cleaning procedures involved: (1) retaining only the most recent submission for duplicate questionnaires identified by the same mobile phone number or WeChat ID, (2) removing questionnaires exhibiting illogical response times, (3) removing questionnaires exhibiting illogical response patterns. Statistical analyses were performed utilizing SPSS 27.0. The level of satisfaction among respondents was characterized using descriptive statistics, including means with standard deviations for continuous variables and percentages for categorical variables. Reliability of the scale was assessed using Cronbach's alpha coefficient (α), while structural validity was evaluated through the Kaiser-Meyer-Olkin (KMO) measure and Bartlett's test of sphericity.; A correlational analysis was conducted to investigate the relationships between the different dimensions of satisfaction and overall satisfaction\u003csup\u003e\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u003c/sup\u003e. Due to the non-normal distribution of satisfaction scores, three or more independent samples were analyzed using the Kruskal-Wallis H test for one-way analysis of socio-demographic characteristics, while two independent samples were analyzed with the Mann-Whitney U test for one-way analysis of significance, with a significance level of p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.Given that linear regression requires continuous variables and the dependent variable was an ordinal categorical variable, multivariate analyses were conducted using an ordered logistic regression model to identify determinants of patient satisfaction. Measurements are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD), and categorical data are conveyed as frequencies and percentages.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eCharacteristics of the study sample\u003c/p\u003e\u003cp\u003eWe collected data from 480 patients. After data cleansing, 433 valid survey responses were kept for data analysis, resulting in an effective recovery rate of 90.2%.\u003c/p\u003e\u003cp\u003eAmong the surveyed inpatient patients, 239 (55.2%) were female. Female patients exhibited marginally lower satisfaction scores than their male counterparts. Individuals over 60 years accounted for the largest proportion (34.4%), followed by those aged 50\u0026ndash;59 years at 20.8%. The percentage of patients under 20 years old was the lowest at 1.4%, although their satisfaction level was the greatest across all age groups. The proportion of patients with a middle school education or lower was the highest at 54.1%, whereas those with a master\u0026rsquo;s degree or more constituted the smallest group. Patients possessing a bachelor\u0026rsquo;s degree or higher exhibited the greatest levels of hospital satisfaction. The predominant income bracket was between 4,001 Yuan and 6,000 Yuan, whereas both high- and low-income groups were considerably smaller. Farmers compromised the largest segment of the occupational groups at 39.7%, whereas students constituted the smallest fraction at 2.8%. Concerning payment options, 82% of patients utilized urban and rural residents' medical insurance, while the other patients relied on out-of-pocket payments or free medical service. The analysis indicates that no statistically significant differences were found in overall satisfaction across subgroups stratified by patients' gender, age, educational attainment, monthly income, and occupation. However, a statistically significant association was identified between payment methods and satisfaction levels (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\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\u003eSummary statistics of hospitalized patients and results of Mann-Whitney U/Kruskal-Wallis \u003cem\u003eH tests\u003c/em\u003e\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\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=\"char\" char=\".\" 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\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eBasic\u003c/p\u003e\u003cp\u003eInformation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGroups\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cem\u003en\u003c/em\u003e(%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eSatisfaction Score\u003c/p\u003e\u003cp\u003e(Mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003eZ/H\u003c/em\u003e Score\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u003cem\u003eP-\u003c/em\u003evalue\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=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e-0.935\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.350\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e194(44.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.54\u0026thinsp;\u0026plusmn;\u0026thinsp;0.846\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e239(55.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.46\u0026thinsp;\u0026plusmn;\u0026thinsp;0.887\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge(years)\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=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.182\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.702\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;20\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e6(1.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.83\u0026thinsp;\u0026plusmn;\u0026thinsp;0.408\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e20\u0026ndash;29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e50(11.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.58\u0026thinsp;\u0026plusmn;\u0026thinsp;0.758\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e30\u0026ndash;39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e60(13.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.32\u0026thinsp;\u0026plusmn;\u0026thinsp;1.066\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e40\u0026ndash;49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e78(18.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.42\u0026thinsp;\u0026plusmn;\u0026thinsp;0.947\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e50\u0026ndash;59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90(20.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.748\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e149(34.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.851\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003cp\u003eLevel\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=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e4.667\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.323\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMiddle school or below\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e237(54.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.826\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school or secondary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e90(20.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.34\u0026thinsp;\u0026plusmn;\u0026thinsp;0.996\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBachelor's degree or college diploma\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e99(22.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.62\u0026thinsp;\u0026plusmn;\u0026thinsp;0.765\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMaster's degree or higher\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e7(1.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.00\u0026thinsp;\u0026plusmn;\u0026thinsp;1.528\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003emonthly\u003c/p\u003e\u003cp\u003eincome(yuan)\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=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e6.342\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.175\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026le;\u0026thinsp;2000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e86(19.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.59\u0026thinsp;\u0026plusmn;\u0026thinsp;0.709\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2001\u0026mdash;4000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e109(25.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.53\u0026thinsp;\u0026plusmn;\u0026thinsp;0.845\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4001\u0026mdash;6000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e119(27.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.51\u0026thinsp;\u0026plusmn;\u0026thinsp;0.862\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e6001\u0026mdash;8000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e58(13.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.941\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;8001\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e61(14.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.28\u0026thinsp;\u0026plusmn;\u0026thinsp;1.035\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOccupation\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=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2.277\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.685\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStudents\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e12(2.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.67\u0026thinsp;\u0026plusmn;\u0026thinsp;0.651\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCorporate/ institutional employees\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e58(13.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.53\u0026thinsp;\u0026plusmn;\u0026thinsp;0.863\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWorkers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e45(10.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.60\u0026thinsp;\u0026plusmn;\u0026thinsp;0.863\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSelf-employed individuals\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e77(17.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.29\u0026thinsp;\u0026plusmn;\u0026thinsp;0.985\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFarmers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e172(39.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.47\u0026thinsp;\u0026plusmn;\u0026thinsp;0.881\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e69(15.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.65\u0026thinsp;\u0026plusmn;\u0026thinsp;0.703\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePayment\u003c/p\u003e\u003cp\u003eMethods\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=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e10.866\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e0.028\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOut-of-pocket\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e31(7.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.23\u0026thinsp;\u0026plusmn;\u0026thinsp;1.146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBasic health insurance\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e355(82.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.50\u0026thinsp;\u0026plusmn;\u0026thinsp;0.865\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFree medical service\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e47(10.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c4\"\u003e\u003cp\u003e4.66\u0026thinsp;\u0026plusmn;\u0026thinsp;0.635\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote. Between-group comparisons were performed utilizing the Mann-Whitney \u003cem\u003eU\u003c/em\u003e test for analyses involving two groups and the Kruskal-Wallis \u003cem\u003eH\u003c/em\u003e test for three or more independent samples.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eReliability and Exploratory Factor Analysis\u003c/p\u003e\u003cp\u003eThe reliability and validity of the questionnaire was evaluated using Cronbach\u0026rsquo;s α coefficient and the Kaiser-Meyer-Olkin (KMO) measure. The Cronbach\u0026rsquo;s α values for the individual dimensions were 0.893, 0.872, 0.901, 0.874, and 0.850, respectively, with an overall α of 0.949, demonstrating strong reliability. The questionnaire data underwent exploratory factor analysis, yielding a KMO score of 0.935 and a significant Bartlett's test of sphericity (χ\u0026sup2; = 6838.470, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), indicating the appropriateness for factor analysis.\u003c/p\u003e\u003cp\u003eCorrelation Analysis of Hospitalized Patients' Satisfaction\u003c/p\u003e\u003cp\u003eDue to the variables' nonconformity to normal distribution, Spearman's rank correlation analysis was conducted, which revealing a significant positive correlation between overall patient satisfaction and all dimensions of healthcare service quality (p\u0026thinsp;\u0026lt;\u0026thinsp;0.01). The results of correlation analysis are shown in Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\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\u003eSpearman Correlation Analysis of Patient Satisfaction Dimensions\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\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\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDimension\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedical Technology\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePatient-Doctor Communication\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eEnvironmental\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMedical Process\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eMedical Expenses\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOverall satisfaction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.516**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.589**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.622**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.465**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.597**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eNote. p\u0026thinsp;\u0026lt;\u0026thinsp;0.01 (two-tailed). Correlation coefficients were calculated using Spearman's ρ.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eFactors associated with patient satisfaction\u003c/p\u003e\u003cp\u003eThe variables included in the model were diagnosed for covariance, revealing tolerances exceeding 0.1 and variance inflation factors below 5, with no multicollinearity between the respective variables; the parallel lines test yielded a p-value of 0.406, surpassing the 0.05 threshold, thereby confirming that the model satisfies the assumption of parallel lines and is suitable for analysis via ordered logistic regression. The independent variables comprise medical technology, doctor-patient communication, environment, medical processes, and medical costs, while the dependent variable is the overall satisfaction. The estimated results revealed that satisfaction with medical technology, doctor-patient communication, environment, medical processes, and medical costs are the main factors affecting inpatient satisfaction and have a significant effect on inpatient satisfaction. The regression results are shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\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\u003eLogistic Regression Analysis of Factors associated with Inpatient Satisfaction\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\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\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\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFactor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eβ\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eOR\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e\u003cem\u003eP\u003c/em\u003e\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eSatisfaction Score (mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eTolerance\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eVIF\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical\u003c/p\u003e\u003cp\u003eTechnology\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.554\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.771\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.010\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.37\u0026thinsp;\u0026plusmn;\u0026thinsp;0.761\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.451\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.220\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePatient-Doctor Communication\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.947\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.495\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.815\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.389\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.568\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEnvironmental Logistics\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.065\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.859\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.11\u0026thinsp;\u0026plusmn;\u0026thinsp;0.841\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.465\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e2.151\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical Process\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.542\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1.734\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.005\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.726\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.619\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.615\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMedical Expenses\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.681\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e2.043\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.000\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4.04\u0026thinsp;\u0026plusmn;\u0026thinsp;0.911\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.522\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1.915\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eParallel-line test (\u003cem\u003ep\u003c/em\u003e)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e0.406\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u0026mdash;\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eNote. β\u0026thinsp;=\u0026thinsp;standardized coefficient; OR\u0026thinsp;=\u0026thinsp;odds ratio; VIF\u0026thinsp;=\u0026thinsp;variance inflation factor. All \u003cem\u003ep\u003c/em\u003e-values are two-tailed.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe survey revealed that the average satisfaction score of inpatients at Wenzhou Medical University Fifth Affiliated Hospital was 4.49\u0026thinsp;\u0026plusmn;\u0026thinsp;0.869, resulting in an overall satisfaction rate of 86.6%. The five dimensions of satisfaction including medical technology (OR\u0026thinsp;=\u0026thinsp;1.740,\u003cem\u003eP\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.010), doctor-patient communication (OR\u0026thinsp;=\u0026thinsp;2.495,\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), environmental factors (OR\u0026thinsp;=\u0026thinsp;2.902,\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001), medical processes (OR\u0026thinsp;=\u0026thinsp;1.720,P\u0026thinsp;=\u0026thinsp;0.005), and medical costs (OR\u0026thinsp;=\u0026thinsp;1.975,\u003cem\u003eP\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) significantly influence inpatient satisfaction.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe research indicated that there is a significant correlation between payment methods and overall satisfaction.Medical technology, doctor-patient communication, environmental factors, medical processes, and medical costs significantly and positively influence inpatient satisfaction. Inpatient satisfaction in the Fifth Affiliated Hospital of Wenzhou Medical University aligns with the general satisfaction levels at domestic public tertiary hospitals. Yet, there remains potential for enhancement when compared to medical institutions that exhibit superior satisfaction rates. For example, hospitals in eastern regions typically exhibit higher satisfaction levels compared to those in central and western regions\u003csup\u003e\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e,\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u003c/sup\u003e. This study indicated that patients' expectations and perceptions of medical services are independent of gender, age, education level, monthly income, or occupation, yet a statistically significant difference exists concerning the method of payment for hospitalization expenses. Additionally, medical costs, doctor-patient communication, environment, medical procedures, and medical technology significantly impact inpatient satisfaction. From a broad view, the differences in inpatient satisfaction levels between domestic and overseas hospitals mostly arises from variations in healthcare systems and cultural expectations\u003csup\u003e\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e,\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e,\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e\u003c/sup\u003e. Furthermore, variations in hospital management tiers and patient sociodemographic attributes contribute to notable disparities in satisfaction levels. From a micro perspective, the efficacy of communication between doctors and nurses in medical services, along with the precision of hospital treatment protocols, are pivotal factors; regarding the hospital environment, factors such as ward conditions and meal quality also affect patient satisfaction; the affordability of medical costs and the accessibility of medical procedures are also significant considerations\u003csup\u003e\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e,\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e\u003c/sup\u003e. These factors are highly consistent with the findings of this study.\u003c/p\u003e\u003cp\u003eCultural values significantly impact patient satisfaction during hospitalization\u003csup\u003e\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e\u003c/sup\u003e. The score for the doctor-patient communication dimension in this survey was 4.17\u0026thinsp;\u0026plusmn;\u0026thinsp;0.815. Effective medical communication can cultivate trust among doctors, nurses, and patients\u003csup\u003e\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e\u003c/sup\u003e, facilitating positive interactions and information exchange between healthcare professionals and patients. In clinical practice, patients often exhibit anxiety, concern, and discomfort during hospital visits, stemming from the unpredictability of disease progression and prognosis\u003csup\u003e\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e\u003c/sup\u003e. Currently, communication skills in diagnosis, treatment, and nursing are of paramount importance. Unprofessional conduct or disregard for patients' emotions may diminish their faith in healthcare providers and can incite confrontations between physicians and patients.\u003c/p\u003e\u003cp\u003eAn optimal hospital environment is essential for safeguarding the physical and mental health of patients, with environmental services serving as a critical indicator of hospital management quality. Environmental services encompass hospital hygiene and cleanliness, signage clarity, nutritional quality and palatability of cafeteria meals, and the adequacy of service facilities. Hospitals need to strengthen environmental management and planning to provide patients with a better medical experience.\u003c/p\u003e\u003cp\u003eA high score in medical procedure dimension indicates that the hospital has well-structured medical protocols that efficiently navigate patients through each stage of the process, including registration, diagnosis, examination, treatment, and medication pickup. The discharge and admission procedures are streamlined, minimizing superfluous waiting and travel time for patients and their families. The hospital provides clear medical guidance to patients, encompassing diagnostic procedures, examination components, and medication instructions, facilitating a seamless medical experience. The medical procedure dimension reflects the hospital's present service quality and highlights opportunities for future enhancement and advancement. By persistently refining medical procedures, enhancing service efficiency, and improving patient experience, the hospital may maintain its competitive advantage in the fiercely contested healthcare industry and cultivate consumers' confidence and loyalty.\u003c/p\u003e\u003cp\u003eThis study revealed a medical technology satisfaction score of 4.35\u0026thinsp;\u0026plusmn;\u0026thinsp;0.726, the highest among all dimensions, suggesting the pivotal significance of medical technology in the overall quality of hospital services. Medical technology includes a wide range of elements, comprising innovative medical devices, professional expertise, clinical experience, and the collaborative capacities of healthcare professionals. These components interconnect to create an integrated medical technology system. The expertise and proficiency of physicians, the complexity of hospital pain management protocols, and the precision and lucidity of treatment regimens significantly influence patient satisfaction.\u003c/p\u003e\u003cp\u003eMedical expenses received the lowest rating across all dimensions. Patients prioritize the transparency of medical charges, the fairness of drug and examination fees, and the clarity of the cost breakdown when seeking medical care. These elements directly or indirectly affect patients' comprehensive assessment and satisfaction with hospital treatment.\u003c/p\u003e\u003cp\u003eThis study has several implications. Hospitals should prioritize the establishment of a patient-centered service system\u003csup\u003e\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e\u003c/sup\u003e, enhance training in service concepts for medical personnel, integrate fundamental medical knowledge with friendly service skills\u003csup\u003e\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e\u003c/sup\u003e, and consistently elevate professional competence and service standards. Hospitals also should enhance patient feedback mechanisms by instituting suggestion boxes, launching service hotlines, and creating online evaluation platforms to collect patient opinions through multiple channels, as well as implementing a rapid response mechanism to promptly analyze and adopt feasible recommendations from patients and continually refine service processes, to deliver superior, more personalized medical care. In terms of the medical environment, it is imperative to prioritize improving the quality of patient room environments. This can be achieved by enhancing lighting and ventilation conditions, strengthening hygiene and cleaning management, and implementing infection control measures to meaningfully enhance patients' hospital stay experience\u003csup\u003e\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e\u003c/sup\u003e. Emphasis should also be placed on the quality of dietary services, offering diverse and nutritionally balanced meal alternatives to accommodate the dietary requirements of different patients\u003csup\u003e\u003cspan citationid=\"CR36\" class=\"CitationRef\"\u003e36\u003c/span\u003e,\u003cspan citationid=\"CR37\" class=\"CitationRef\"\u003e37\u003c/span\u003e\u003c/sup\u003e. Additionally, the hospital's signage system requires enhancement to provide clear and succinct directional instructions, allowing patients and their families to quickly locate target areas. A well-thought-out spatial layout and robust infrastructure maintenance are crucial for creating a safe, comfortable, and convenient medical environment for patients. In addition to these foundational steps, hospitals can significantly improve triage efficiency by implementing an intelligent admission system\u003csup\u003e\u003cspan citationid=\"CR38\" class=\"CitationRef\"\u003e38\u003c/span\u003e\u003c/sup\u003e that integrates appointment scheduling, registration processes, and payment functions through advanced medical information technology. Investing in self-service kiosks is another key move, enabling a shift from reactive assistance to anticipatory service delivery\u003csup\u003e\u003cspan citationid=\"CR39\" class=\"CitationRef\"\u003e39\u003c/span\u003e\u003c/sup\u003e and thereby streamlining patient workflows. Furthermore, hospitals should prioritize the acquisition of advanced medical technologies to enhance diagnostic accuracy and therapeutic efficacy. This should be accompanied by the establishment of comprehensive training programs to ensure that medical staff are proficient in applying these emerging technologies\u003csup\u003e\u003cspan citationid=\"CR40\" class=\"CitationRef\"\u003e40\u003c/span\u003e\u003c/sup\u003e, which will ultimately enhance patient care experiences. To ensure financial transparency, hospitals must implement real-time cost tracking systems through verified digital channels, providing patients with immediate access to detailed treatment expenditures\u003csup\u003e\u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e41\u003c/span\u003e\u003c/sup\u003e. Standardized physician-patient communication protocols should also be established, requiring clinicians to comprehensively explain both the clinical rationale for medications and their associated costs during prescription. To further bolster patients' understanding of medical reimbursement policies\u003csup\u003e\u003cspan citationid=\"CR42\" class=\"CitationRef\"\u003e42\u003c/span\u003e\u003c/sup\u003e, hospitals should establish dedicated insurance consultation counters and conduct professional education programs. Lastly, collaborating with social welfare organizations to set up medical assistance funds can offer much-needed financial support and fee reductions for economically disadvantaged patients.\u003c/p\u003e\u003cp\u003eThere are also limitations worth noting. First, the study sample primarily originated from a specific region and a hospital, potentially limiting its representativeness and influencing the generalizability of the findings to other regions, healthcare facilities, and heterogeneous populations. Second, the study employed a cross-sectional design without longitudinal follow-up data, making it difficult to elucidate the dynamic patterns of patient satisfaction over time. Third, the study methodology exclusively utilized quantitative analysis, and did not incorporate qualitative research to explore patient experiences in depth, which may have overlooked other factors related to patient experience. Finally, the study did not conduct specific analyses for patients from different cultural backgrounds, which may affect the cross-cultural applicability of the conclusions.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003ePatient satisfaction during hospitalization is one of the key indicators for assessing the quality of healthcare services, directly impacting public fulfillment and happiness. Understanding and improving patient satisfaction is of great significance for advancing the quality of healthcare institutions. This study is based on questionnaire survey data collected from inpatients at the Fifth Affiliated Hospital of Wenzhou Medical University between October and November 2024. Descriptive statistical analysis, rank sum tests, and ordered logistic regression methods were used to explore the key factors affecting inpatient satisfaction. The study found that patient satisfaction during hospitalization is influenced by six key factors: doctor-patient communication, medical technology, hospital environment, medical processes, and medical costs. It is important to note that the specific manifestations of these influencing factors may vary depending on the characteristics of the study population, regional differences, and cultural backgrounds. Healthcare facilities should concentrate on these pivotal influencing aspects to create focused quality improvement programs, to methodically elevate the quality of healthcare services and patient satisfaction.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003ch2\u003eCompeting interests\u003c/h2\u003e\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\u003c/p\u003e\u003cp\u003e\u003ch2\u003eHuman Subject Research Approval\u003c/h2\u003e\u003cp\u003e This study was reviewed and approved by Internal Review Board at ID:2024(Ⅰ)-067-01.\u003c/p\u003e\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eCX and JJ conceived the idea. JJ and YS supervised the work. CX performed data collection, conducted statistical analysis, and drafted the first version of the manuscript. CX, YS, and XX participated in manuscript revision and critical editing. All authors contributed to the interpretation of results, revisions, and final approval of the paper.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThis study was supported by the Fifth Affiliated Hospital of Wenzhou Medical University. No funding was available for this study.We thank Luyanda Z Ngongoma, Jerry Song, and Ella Shi for valuable comments and edits.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe de-identified datasets are available upon request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eFerreira, D. C. et al. Patient satisfaction with healthcare services and the techniques used for its assessment: a systematic literature review and a bibliometric analysis. \u003cem\u003eHealthc. (Basel)\u003c/em\u003e \u003cstrong\u003e11\u003c/strong\u003e, 639 (2023).\u003c/li\u003e\n\u003cli\u003eZusman, E.E. 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Nevertheless, comprehension of the elements influencing patient satisfaction remains limited. This study aims to evaluate inpatient satisfaction through a survey. We conducted a survey of 433 patients at the Fifth Hospital Affiliated with Wenzhou Medical University using a stratified random sampling technique to provide scientific evidence for enhancing inpatient satisfaction. The Kruskal-Wallis test and ordered logistic regression were utilized to examine the relationship between inpatient satisfaction and its influencing factors. The results indicated that the average inpatient satisfaction score was 4.49, with higher scores for medical process and medical technology, and the lowest score for medical cost. Univariate analysis revealed a significant association between payment methods and overall satisfaction. Ordered logistic regression indicated that inpatient satisfaction increased with higher scores in all dimensions of healthcare service quality. Medical technology, doctor-patient communication, environmental factors, medical processes, and medical costs significantly and positively influence inpatient satisfaction. The overall satisfaction with inpatient services is affected by multiple factors, and enhancements can be achieved by optimizing doctor-patient communication, improving the hospital environment and facilities, and standardizing the medical service process.\u003c/p\u003e","manuscriptTitle":"Patient Satisfaction and its Influencing Factors: Results from a survey in inpatient department in a tertiary hospital setting in China","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-17 10:18:02","doi":"10.21203/rs.3.rs-7055229/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b529023a-18dc-4111-9a10-b4e01694c22e","owner":[],"postedDate":"July 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":51501278,"name":"Health sciences/Health care"},{"id":51501279,"name":"Health sciences/Health occupations"},{"id":51501280,"name":"Health sciences/Medical research"}],"tags":[],"updatedAt":"2025-10-22T14:53:16+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-17 10:18:02","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7055229","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7055229","identity":"rs-7055229","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}