title: Explaining public satisfaction with health-care systems: findings from a nationwide survey in China.
abstract: To identify factors associated with health-care system satisfaction in China.
  
  
  
  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.
  
  
  
  Stratified nationwide survey sample analysed using multilevel logistic regression.
  
  
  
  3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013.
  
  
  
  Satisfaction with the way the health-care system in China is run.
  
  
  
  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.
  
  
  
  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.
authors.affiliation: School of Social and Political Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Neil
authors.identifier: 0000-0001-9694-9701
authors.initials: N
authors.lastname: Munro
authors.affiliation: School of Social and Political Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Duckett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002681:China; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006302:Health Services Research; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007182:Income; D019458:Insurance Coverage; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: China; health systems; performance; public perceptions; satisfaction