Comparison of expectations for health services between inpatients from mental health department and endocrinology department in China

Abstract

Background: Patient expectations for health services refer to the anticipation or the belief about what should be encountered in the healthcare system. Understanding patient expectations can improve patient satisfaction and healthcare compliance. It is particularly important for patients with mental disorders, as greater healthcare compliance is required for them due to the chronic and relapsing nature of their diseases. However, little is known about expectations among Chinese patients with mental disorders. Objective: To examine expectations for healthcare among patients with mental disorders and to compare them with those of patients with chronic physical diseases. Patients and methods: A cross-sectional survey was conducted among two inpatient groups, consecutively recruited from the Mental Health Department (MHD) and Endocrinology Department (ED) in one tertiary general hospital in Changsha, China. Patient expectations were measured by eight translated and modified vignettes of health system responsiveness. Group differences were compared using Chi-square tests for sociodemographic and clinical characteristics and Z-test for expectation rating. Logistic regression was performed to test whether group differences of expectations remained statistically significant after controlling for socio-demographic and clinical variables. Results: Most patients from MHD rated scenarios in vignettes on communication, choice of provider, autonomy, and social support as “meeting expectations”, and rated scenarios in vignettes on prompt attention, dignity, confidentiality, and quality of basic amenities as “below expectations”. In comparison, patients from MHD had similar expectations with their counterparts from ED, for prompt attention, dignity, confidentiality, communication, choice of provider, and social support; however, patients fromMHD had significantly lower expectations in quality of basic amenities and higher expectations in autonomy, after adjusting for socio-demographic and clinical factors. Conclusion: Like their counterparts with physical diseases, patients with mental disorders also expect prompt attention, dignity, confidentiality, communication, choice of provider, and social support in their interaction with the healthcare system. Moreover, extra attention to autonomy is needed for patients with mental disorders to meet their expectations and improve patient satisfaction.