Health service satisfaction (outcome variables)

In the 2013 CGSS questionnaire, 10 health services’ satisfaction was investigated separately, including: (a) essential drug regime, (b) drug safety management, (c) hygiene supervision management (food, drinking water, public places, etc.), (d) severe mental illness management, (e) chronic disease management, (f) urban and rural residents’ health file service, (g) preventive vaccination, (h) infectious disease prevention, (i) special population health care (children, women, and the old), and (j) health education service. Five scores measured each health service’s satisfaction: 5—very satisfied, 4—satisfied, 3—neutrality, 2—dissatisfied, and 1—very dissatisfied.

For better understanding the satisfaction with health service, exploratory factor analysis (EFA) was used for dimensionality reduction. Before applying the EFA, the Kaiser-Meyer-Olkin (KMO) measure of sampling adequacy test and Bartlett Test of Sphericity were applied to find the applicability of factor analysis. After calculation, KMO was 0.89, which exceeded 0.5, and Bartlett’s Test of Sphericity also vindicated the applicability of factor analysis (χ²: 27036.973, P < .001). Then the EFA was conducted. The extraction method is principal component analysis (PCA). The results were presented in Table 1 and the 10 health services were described as items in the table. The table showed that out of 10 variables used in the study, 2 factors were explored, which were capable of explaining 63.049% of the variance among variables. Of which 34.565% was explained by factor 1, and 28.484% was explained by factor 2. Overall, the results of the factor analysis were acceptable.

Factor Analysis for Health Service Satisfaction.

Further combining each health service’s specific content, factor 1 could be labeled “Health management service” and factor 2 could be labeled “Public health service” according to the main content covered by each factor and related research.²⁵ The total satisfaction score for each factor was calculated. The medians of the total score were 18 for factor 1 and 14 for factor 2. For each factor, the satisfaction was defined as “satisfied” if the score ≥median score; otherwise, the satisfaction was described as “not satisfied.”