title: How patients think about social responsibility of public hospitals in China?
abstract: Hospital social responsibility is receiving increasing attention, especially in China where major changes to the healthcare system have taken place. This study examines how patients viewed hospital social responsibility in China and explore the factors that influenced patients' perception of hospital social responsibility.
  
  
  
  A cross-sectional survey was conducted, using a structured questionnaire, on a sample of 5385 patients from 48 public hospitals in three regions of China: Shanghai, Hainan, and Shaanxi. A multilevel regression model was employed to examine factors influencing patients' assessments of hospital social responsibility. Intra-class correlation coefficients (ICCs) were calculated to estimate the proportion of variance in the dependent variables determined at the hospital level.
  
  
  
  The scores for service quality, appropriateness, accessibility and professional ethics were positively associated with patients' assessments of hospital social responsibility. Older outpatients tended to give lower assessments, while inpatients in larger hospitals scored higher. After adjusted for the independent variables, the ICC rose from 0.182 to 0.313 for inpatients and from 0.162 to 0.263 for outpatients. The variance at the patient level was reduced by 51.5 and 48.6 %, respectively, for inpatients and outpatients. And the variance at the hospital level was reduced by 16.7 % for both groups.
  
  
  
  Some hospital and patient characteristics and their perceptions of service quality, appropriateness, accessibility and professional ethics were associated with their assessments of public hospital social responsibility. The differences were mainly determined at the patient level. More attention to law-abiding behaviors, cost-effective health services, and charitable works could improve perceptions of hospitals' adherence to social responsibility.
authors: School of Public Health, Key Lab of Health Technology Assessment (Ministry of Health), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 197 Mailbox, 138 Yixueyuan Road, Xuhui District, Shanghai, 200032, China.
authors: Wenbin
authors: W
authors: Liu
authors: School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, 70112, USA.
authors: Lizheng
authors: L
authors: Shi
authors: Centre for Rural and Northern Health Research and Northern Ontario School of Medicine, Laurentian University, Sudbury, ON, P3E 2C6, Canada.
authors: Raymond W
authors: RW
authors: Pong
authors: School of Public Health, Key Lab of Health Technology Assessment (Ministry of Health), Collaborative Innovation Center of Social Risks Governance in Health, Fudan University, 197 Mailbox, 138 Yixueyuan Road, Xuhui District, Shanghai, 200032, China. yychen@shmu.edu.cn.
authors: Yingyao
authors: Y
authors: Chen
mesh_terms: D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011362:Professional Corporations / Q000941:ethics*; D012941:Social Responsibility; D011795:Surveys and Questionnaires
keywords: China; Multilevel regression analysis; Public hospital; Social responsibility