Patient Satisfaction with Community Health Service Centers as Gatekeepers and the Influencing Factors: A Cross-Sectional Study in Shenzhen, China.

Shenzhen is the first pilot city in China implementing the gatekeeper policy, with community health service (CHS) centers as the gatekeepers. We aim to investigate patient satisfaction with this policy and its influencing factors in Shenzhen. 3,848 patients visiting eight CHS centers in Shenzhen of China between May 1 and July 28, 2013 were recruited. We interviewed them using a structured questionnaire to investigate their satisfaction with the gatekeeper policy of CHS. Multivariable logistic regression models were used to identify influencing factors. Of the respondents, 28.17%, 47.27% and 24.56% were satisfied with, neutral to, and not satisfied with the gatekeeper policy respectively. Patient satisfaction with this policy was found to be associated with education level, familiarity with the policy, referral experience, satisfaction with convenience of seeing a doctor, satisfaction with waiting time, satisfaction with medical facility, satisfaction with general medical practitioners’ professional skill, and proportion of expense reimbursed. Our investigation shows that patient satisfaction with the gatekeeper policy was low. To improve patient satisfaction, efforts should be made to increase the convenience of seeing a doctor in community, shorten waiting time, improve general medical practitioners’ professional skill, and increase proportion of expense reimbursement.

深圳是中国首个实施守门人政策的试点城市，以社区卫生服务中心作为守门人。我们旨在调查深圳患者对该政策的满意度及其影响因素。 2013年5月1日至7月28日期间，在中国深圳8个社区卫生服务中心就诊的3848名患者被纳入研究。我们使用结构化问卷对他们进行访谈，以调查他们对社区卫生服务守门人政策的满意度。采用多变量逻辑回归模型来确定影响因素。 在受访者中，分别有28.17%、47.27%和24.56%的人对守门人政策表示满意、持中立态度和不满意。研究发现患者对该政策的满意度与教育水平、对政策的熟悉程度、转诊经历、对就医便利性的满意度、对候诊时间的满意度、对医疗设施的满意度、对全科医生专业技能的满意度以及费用报销比例有关。 我们的调查显示患者对守门人政策的满意度较低。为提高患者满意度，应努力提高社区就医的便利性，缩短候诊时间，提高全科医生的专业技能，并提高费用报销比例。