Can socio-economic differences explain low expectation of health services among HIV patients compared to non-HIV counterparts?

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  • Additional Information
    • Source:
      Publisher: BioMed Central Country of Publication: England NLM ID: 100968562 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2458 (Electronic) Linking ISSN: 14712458 NLM ISO Abbreviation: BMC Public Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BioMed Central, [2001-
    • Subject Terms:
      Patient Satisfaction* ; Quality of Health Care*; HIV Infections/*psychology; Adult ; Age Factors ; China ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Minority Groups ; Socioeconomic Factors ; Time Factors
    • Abstract:
      Background: The health service of China has encountered significant challenges due to inequalities in socio-economic determinants of health. HIV patients are known to suffer from social stigma, and may receive inadequate responsiveness from health providers. Before assessing the responsiveness they receive, it is important to know their expectations. We aimed to compare levels of expectation towards the healthcare service among HIV and non-HIV patients with adjustment for socio-economic factors.
      Methods: A cross-sectional study was conducted during January and February, 2015 among two consecutive groups of HIV positive and non-HIV patients in two hospitals in Kunming, China. Patients' expectation towards eight domains of health system responsiveness was measured using 40 vignettes; five per domain. Each vignette was ranked from 1 "very good" to 5 "very bad", and the responses were summed to obtain a total score for each domain. Differences in total scores were compared between the two groups and adjusted for other factors using multiple linear regression.
      Results: The three domains with the highest scores, reflecting high expectation, were prompt attention, basic amenities and choice. Adjusted for other factors, HIV patients had significantly lower levels of expectation in all domains compared to the non-HIV group. Age was associated with the basic amenities domain, with young adults having higher expectations than other age groups. Minority ethnic groups had lower expectation towards dignity, prompt attention and autonomy domains compared to Han ethnicity. Those who lived in a home with 2-4 family members had higher expectations towards confidentiality than those who lived alone.
      Conclusion: Patients with HIV have significantly lower levels of expectations even after adjusting for socio-economic factors. Assessment of health system responsiveness based on their judgments above may give biased results toward favorable service quality.
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    • Contributed Indexing:
      Keywords: China; Expectation; HIV patients; Health system; Socio-economic factors
    • Publication Date:
      Date Created: 20160911 Date Completed: 20170816 Latest Revision: 20220318
    • Publication Date:
      20231215
    • Accession Number:
      PMC5016867
    • Accession Number:
      10.1186/s12889-016-3609-5
    • Accession Number:
      27613368