{
  "abstract": "Objectives Patients’ sense of gain experience (PSGE) is the comprehensive feeling throughout the treatment process, which is a critical benchmark for evaluating comprehensive medical and health system reform in China. This study aims to assess the current status of PSGE in public hospitals and identify important associated factors, providing evidence-based recommendations for improving healthcare services.Design This was a cross-sectional study conducted from October to November 2023.Setting A total of 14 public hospitals in Foshan, Guangdong Province, China.Participants There were 3223 responses, including 1592 from outpatients and 1631 from inpatients.Primary outcome measure PSGE was assessed across five domains: time accessibility, service accessibility, cost affordability, patient participation and efficacy predictability. Participants were also asked to provide an overall rating of the PSGE.Results The overall score for PSGE was 4.47±0.53 (mean±SD), with service accessibility receiving the highest score (4.68±0.50) and affordability the lowest (4.17±0.86). Secondary hospitals scored an overall PSGE of 4.55±0.50, while tertiary hospitals scored 4.42±0.54. Key factors associated with PSGE were overall satisfaction (β=0.164, p<0.001), treatment satisfaction (β=0.187, p<0.001), satisfaction with medical reforms (β=0.149, p<0.001), patient loyalty (β=0.072, p=0.001) and hospital reputation (β=0.223, p<0.001).Conclusions This study found that patients reported a positive PSGE with service accessibility but reported a less positive PSGE with cost affordability. A tier-based disparity was evident, with secondary hospitals outperforming tertiary hospitals in overall PSGE outcome. Stronger PSGE was positively associated with higher scores in overall satisfaction, treatment satisfaction, satisfaction with medical reforms, patient loyalty and hospital reputation. Demographic and institutional factors, such as hospital level, patient type and household registration, were associated with the PSGE. Efforts can be focused on enhancing clinicians’ willingness and competence in discussing treatment costs during clinical encounters. It is essential for policymakers to address disparities in healthcare experiences among patient groups across hospital tiers to advance equitable, patient-centred systems.",
  "authors": [
    {
      "affiliations": [
        "Department of Social Medicine and Health Management, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China",
        "Centre for Research on Health Economics and Health Promotion, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China"
      ],
      "name": "Ping Xia"
    },
    {
      "affiliations": [
        "School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China"
      ],
      "name": "Baofang Liang"
    },
    {
      "affiliations": [
        "School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China"
      ],
      "name": "Qi Zeng"
    },
    {
      "affiliations": [
        "Department of Public Health, College of Health Professions, Marshall University, Huntington, West Virginia, USA",
        "Global Health Institute, Marshall University, Huntington, West Virginia, USA"
      ],
      "name": "Liang Wang"
    },
    {
      "affiliations": [
        "Centre for Research on Health Economics and Health Promotion, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China"
      ],
      "name": "Lixiang Zhai"
    },
    {
      "affiliations": [
        "School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China"
      ],
      "name": "Meiying Li"
    },
    {
      "affiliations": [
        "School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China"
      ],
      "name": "Lieshen Chen"
    },
    {
      "affiliations": [
        "Department of Population Health, New York University Grossman School of Medicine, New York, New York, USA"
      ],
      "name": "Haofan Yang"
    },
    {
      "affiliations": [
        "Department of Social Medicine and Health Management, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China",
        "Centre for Research on Health Economics and Health Promotion, Guangdong Pharmaceutical University, Guangzhou, Guangdong, China"
      ],
      "name": "Haiyan He"
    },
    {
      "affiliations": [
        "School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China"
      ],
      "name": "Xingying Xu"
    },
    {
      "affiliations": [
        "School of Public Health and Management, Guangzhou University of Chinese Medicine, Guangzhou, China"
      ],
      "name": "Wenjin Gong"
    }
  ],
  "title": "Patients’ sense of gain experience and its influencing factors: a cross-sectional study in Foshan, China",
  "uid": "fd6c738a-caa2-5dbd-a5b9-09cc2ade1679"
}