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Objectives To evaluate disparity in service quality between second- and third-tier hospitals and explore factors that affect patients' perception of service quality in China. Design Cross sectional study. Setting Twelve hospitals in China. Participants 5714 patients. Intervention None. Main Outcome Measure Total score of the SERVQUAL scale and each of its five dimensions. Results Patients from third-tier hospitals rated significantly higher scores overall and in all the five dimensions of the SERVQUAL scale. Those with lower education, urban residents and those who had higher degree of life satisfaction and attention paid to health perceived higher service quality. Inpatients perceived higher service quality compared with outpatients. Conclusion We found a significant gap in patient's perceived service quality between second- and third-tier hospitals in China. A variety of demographic and personality factors were found to significantly influence patient's perceived service quality.

Perceived health-care quality in China: a comparison of second- and third-tier hospitals