Background: To investigate urban and rural residents' perceptions on the issue of "difficult access to quality medical services and expensive medical bills" (difficult and expensive medical services) 10 years after the implementation of medical and health care system reform in China.
Methods: we conducted a cross-sectional questionnaire survey of residents in a middle province of China. Multi-stage stratified random sampling was utilized to sample a total of 1968 residents of three cities in the middle province in July 2019.
Results: Residents in the province were highly satisfied with the solution of "difficult and expensive medical services", with the satisfaction rate reaching 70%. However, satisfaction differed among the surveyed cities. 83.4% of the residents reported "difficult and expensive medical services"as their current major concern. Complex medical procedures (31.25%) and high inspection costs (51.68%) were the main reasons for "difficult and expensive medical services". Other reasons include the provision of medical and health resources, the service awareness of medical and health care personnel, people's health needs, and the perceptions of health, etc.
Conclusions: The issue of "difficult and expensive medical services" is a social issue requiring constant attention.