西部農(nóng)村居民對(duì)醫(yī)療服務(wù)的認(rèn)知：基于消費(fèi)者決策過(guò)程理論的實(shí)證研究

　　With a rapid growth of health expenditure in China， using available healthcare resources in a more efficient and equitable way has become an important issue. Although health care delivery system improvement and universal health insurance have been implemented since the health reform，many backward regions still face the limited accessibility of health resources and inequity of health care performance. Analyzing patient health demand and perception of health care service performance in rural regions is essential for evaluating the overall efficiency and performance of medical services，Previous studies had explored the Chinese outpatient health seeking behavior and satisfaction in developed areas and tertiary hospitals. Considering the lower education level， less individual income and heavier economic burden，it is necessary to conduct a region-specific questionnaire survey for the outpatient's perception in rural western China. The main framework of the field study was constructed based on the consumer decision process theory，based on which outpatient satisfaction and choice of health care providers and relevant factors were investigated， to explore outpatients' perception of health care provider in rural western China.Eleven provincial level divisions in western China were chosen as sample provinces， all counties in each province were divided into three levels by GDP per capita， and one sample county were randomly stratified from each level of 11 provinces. The local county general hospital， the county maternal and child health center （MCH）， the county hospital of traditional chinese medicine （TCM） in each sample county were chosen as sample county hospitals， and 2-3 township health centers in each sample county were systematical selected as sample township hospitals. Fifty outpatients randomly drawn from each county hospital and 30 patients from each township health center were enrolled into the questionnaire survey. Written informed consent was obtained from all interviewees before filling the questionnaire.Questionnaire was composed based on the literature review. to survey outpatient choice and satisfaction. Outpatient choice of care providers was explored through a single-choice question， with participant characteristics investigated as internal factors， while external factors were analyzed through a multiple-choice question. Multinomial logistic regression and Chi-Square analysis was conducted to study the relevant factors. Questionnaire composed of nine 5-Likert items was applied to survey the primary health care outpatient satisfaction. Exploratory factor analysis （EFA） was conducted to study the factor structure of questionnaire. Stepwise multi-linear regression analysis was performed to study the influencing factors.

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