How do Chinese people perceive their healthcare system? Inequality in public satisfaction with healthcare security

Bibliographic Data

ID22082921
AuthorsShengxian Bi (Huazhong University of Science and Technology), Huawei Tan (Huazhong University of Science and Technology), Dandan Guo (0000-0002-6681-0343, Huazhong University of Science and Technology), Xinyi Peng (0000-0002-6003-2392, Huazhong University of Science and Technology), Qijiao Yang (Huazhong University of Science and Technology), Tsung-Han Weng (Beijing Normal University, corresponding author), Yingchun Chen (0000-0001-9400-0308, Rural Development Institute, corresponding author)
Year2025
Volume13
Pages1529964-1529964
Publication date2025-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1529964
PMID40376066
OpenAlexW4410014370
LanguageEN
References cited47

Background: Satisfaction with healthcare security is a critical indicator of the effectiveness of health systems. Social equity and trust and the financial burden of healthcare are key socioeconomic factors that can significantly influence residents' perceptions of healthcare security. This study aims to investigate the impact of social equity and trust and medical burden on satisfaction with healthcare security and to analyze their potential interaction mechanisms. Methods: Using data from 7,052 participants in the 2021 China General Social Survey, this study employed machine learning methods, including neural networks (NN), random forests (RF), and logistic regression (LR), to predict and classify satisfaction with healthcare security. Additionally, causal inference techniques were applied to identify the key determinants and estimate their effects on satisfaction levels, thereby uncovering the underlying causal mechanisms. Results: < 0.001). In the original models, the AUCs for LR, NN, and RF were 0.549, 0.563, and 0.534, respectively. After including factors related to social equity and trust, the AUCs for LR, NN, and RF improved to 0.633, 0.638, and 0.611, respectively. Among the three ML models, medical expenses and social equity and trust were identified as the most influential factors. Further causal analysis confirmed that higher levels of social equity and trust increased satisfaction with healthcare security, while a heavier medical burden reduced it. The analysis also revealed significant marginal effects, suggesting that the impact of social equity and trust varied across different levels. Conclusion: This study highlights the complex relationship between social equity and trust, medical burden, and satisfaction with healthcare security, offering theoretical support for understanding residents' perceptions of healthcare security in various social contexts

Business · Economic growth · Economics · Health care · Healthcare system · Inequality · Internet privacy · Patient satisfaction · Political science · Public healthcare · Social security · Computer Science · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing · Patient Satisfaction in Healthcare

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