What do patients care most about in China's public hospitals? Interviews with patients in Jiangsu Province

Background: Evaluations on different aspects of the performance of public hospitals in China have been conducted, usually based on indicators developed by literature review and expert suggestions. The patient perspective was not always considered. This study aims to identify what patients care most about in China's public hospitals exclusively from a patient perspective. Methods: A mix of stratified sampling and typical sampling was used to select 15 public hospitals in Jiangsu Province of China. In each sampled hospital, a convenient sample of six outpatients and six inpatients was selected to conduct face-to-face individual interviews. An interview guide consisting of six open-ended questions was designed. Donabedian's quality of care framework was applied to categorize themes and subthemes, which were generated from patients' interviews by using the conventional content analysis approach. Frequencies of themes and subthemes were counted. Results: Nine key themes were identified regarding patients' concerns about hospital care, which were environment and facilities, professional competence, hospital reputation, and morals of medical staff in the "structure" category of Donabedian's framework, caring attitudes and emotional support, medical costs, communication and information, and efficiency and coordination of care in the "process" category, and health outcomes in the "outcome" category. Conclusions: This study has identified and prioritized the aspects that patients care most about in China's public hospitals in Jiangsu Province exclusively from a patient perspective. A measurement tool of patient-reported experiences in public hospitals could be built based on this study. Efforts should be made to represent the patient perspective to further improve the reform of public hospitals in China.