| Sumario: | Objective: To identify factors associated with health ‐ care system satisfaction in China. Context: 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. Design: Stratified nationwide survey sample analysed using multilevel logistic regression. Setting and participants: 3680 Chinese adults residing in family dwellings between 1 November 2012 and 17 January 2013. Main outcome measure: Satisfaction with the way the health ‐ care system in China is run. Results: 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. Conclusions: 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.
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