This is a nationwide survey of adults in mainland China that explored attitudes towards health care, including how people evaluate their health system and their trust in doctors and health care providers. It also includes data on respondents’ health-related behaviours and utilization of preventive and other health services, as well as trust in political institutions, cultural values, economic status, social capital and standard demographic variables.This interdisciplinary project establishes a new collaboration among UK researchers and a leading Chinese social research team, to conduct the first major study of Chinese people's attitudes towards their health care. The project's core theoretical contribution is to understanding the relationships between attitudes and health-related behaviours, focussing particularly on how people evaluate their health system, their trust in doctors and the health system, and their utilization of preventive and curative health services. Previous quantitative research on health in China has examined the influence on utilization of age and gender, incomes, insurance protection, distance to health service providers and perceived health care needs. Yet work done in other countries has shown that attitudes, including performance evaluations and trust, can impact on people's decisions about when and where to use health services. At the same time, qualitative studies in China have suggested that people are often critical of performance and that there is a crisis of trust in doctors and the health care system. Our project is the first systematic study of these attitudes and how they influence utilization.
The Research Center for Contemporary China at Peking University carried out fieldwork from 1 November 2012 to 17 January 2013. The target population was mainland Chinese citizens age 18 to 70 residing for more than 30 days in family dwellings in all 31 provinces. The survey used the GPS Assisted Area Sampling Method (Landry & Shen, 2005) to project a grid onto 2855 counties, county-level cities or urban districts of the same status. Stratification took place in stages. At the first stage, the country was divided into three official macro-regions, Eastern, Central and Western; each macro-region was divided into urban and rural administrative areas, giving six layers in total; 60 primary sampling units (PSU) corresponding to county-level administrative divisions were selected at random across the six layers with probability proportionate to population (see map below). Within each PSU, three half-square minutes (HSM) of latitude and longitude were chosen with probability proportionate to population density, within each of these, again proportionate to population density, a number of spatial square seconds (SSS) corresponding to 90m x 90m squares was selected at random. Within each SSS, all dwellings were enumerated, and 27 were selected in each HSM by systematic sampling. Within each dwelling respondents were identified by the Kish method. The result was a sample of 5,424 dwellings in which 3,680 valid interviews were completed, giving a response rate of 67.9 per cent.
