Abstract
OBJECTIVE: To identify factors associated with health-care system satisfaction in China. CONTEXT: Recent research suggests that socio-demographic characteristics, self-reported health, income and insurance, ideological beliefs, health-care utilization, media use and perceptions of services may affect health-care system satisfaction, but the relative importance of these factors is poorly understood. New data from China offer the opportunity to test theories about the sources of health-care system satisfaction. DESIGN: Stratified nationwide survey sample analysed using multilevel logistic regression. SETTING AND PARTICIPANTS: 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. MAIN OUTCOME MEASURE: Satisfaction with the way the health-care system in China is run. RESULTS: We find only weak associations between satisfaction and socio-demographic characteristics, self-reported health and income. We do, however, find that satisfaction is strongly associated with having insurance and belief in personal responsibility for meeting health-care costs. We also find it is negatively associated with utilization, social media use, perceptions of access as unequal and perceptions of service providers as unethical. CONCLUSIONS: To improve satisfaction, Chinese policymakers - and their counterparts in countries with similar health-care system characteristics - should improve insurance coverage and the quality of health services, and tackle unethical medical practices.