Factors associated with patient satisfaction in emergency department in mainland China, Hong Kong and Taiwan : a systematic review

Abstract

Background Patient satisfaction is an important assessment of hospital’s service quality. Patients from emergency department (ED) usually have high expectation on receiving timely and high quality medical service. They generally have low patient satisfaction. Patient satisfaction has been identified to be associated with willingness to return and recommendation of the medical service to others. Therefore, to identify the factors associated with patient satisfaction in ED is important. Factors associated with patient satisfaction could vary by different ED systems. This project aimed at synthesizing factors associated with patient satisfaction in ED in Mainland China, Hong Kong and Taiwan, and comparing the different factors associated with patient satisfaction among the three areas and make recommendations on interventions to improve patient satisfaction in ED.

Methods This review retrieved published literatures from PubMed, CNKI, and Taiwan electronic periodical services (TEPS). There is no restriction on study design, study population and measurements of patient satisfaction. Studies reporting factors associated with patient satisfaction in ED, and studies reporting effective interventions of improving patient satisfaction in ED were included. A total of 20 including 12 studies about Mainland China, two studies about Hong Kong and six studies about Taiwan were included.

Results Common factors associated with patient satisfaction in emergency services have been identified in Mainland China, Hong Kong and Taiwan as well as other countries. These common factors included patients' characteristics, technical skills of medical staff, service attitudes, communication skills, professional ethics, provision of sufficient information, waiting time, allocation of resources and physical environment of ED. Different health systems can explain some unique factors identified in different areas. Satisfaction with medical expenses has been identified as a factor associated with overall patient satisfaction of ED in Mainland China, which could be due to that patients in Mainland have higher out-of-pocket share. Hong Kong has a gate keeper system which results in a large number of inappropriate ED users and thereby increases the waiting time and causes the ED crowding.

Conclusion On the basis of the identified factors, potential interventions such as providing patients with sufficient information and improving medical staff’s technical skills, service attitude and communication skills can be implemented to increase patient satisfaction. Future studies should focus more on the evaluation of specific interventions.