Objective  To examine the overall satisfaction to medical service and its influencing factors among inpatients in tertiary maternal and child health institutions two years after the implementation of the National Healthcare Improvement Initiative, and to propose recommendations for improving medical service in maternal and child health institutions.

  Methods  The data on 9 802 inpatients were extracted from surveys of Third Party Evaluation on Satisfaction to Medication in 33 maternal and child health institutions across China and the surveys were conducted during 2015 and 2016 under the National Healthcare Improvement Initiative. Multilevel linear model was used to analyze influencing factors of satisfaction to medical service among the inpatients.

  Results  The overall score of satisfaction to medical service was 4.59 ± 0.63 for all the inpatients. Among the 15 domain satisfaction scores, the highest was 4.70 ± 0.58 for nurses′ kindness during care service and 4.70 ± 0.56 for doctors′ patience when inquiring illness condition; whereas the lowest was 3.11 ± 2.16 for clear pathway for praising or complaining. Among influencing factors for the overall satisfaction of the inpatients, the strongest was reasonable hospitalization expenditure and its clear list for the expenditure-related medical service items (β = 0.174 3, t = 24.53, P < 0.001) , followed by perceived respect and comfort from medical staff (β = 0.123 0, t = 11.15, P < 0.001), doctors' patience when inquiring illness condition (P < 0.001) and nurses′ kindness during care (P < 0.001).

  Conclusion  Medical cost still plays a critical role on satisfaction to medical service among inpatients in maternal and child health institutions, but medical staff's service attitude becomes an important factor of satisfaction to medical service among inpatients; the results suggest that optimizing medical resources allocation and strengthening nursing care are key points for improving hospitalization medication.