Objective  To analyze the influence of hospital competition on trust and satisfaction towards medical service among in- and out-patients in China.

  Methods  The data on two-weeks outpatient and yearly hospitalization utilization among 57 529 residents in 27 000 urban and rural households across Shaanxi province in 2013 were extracted from the 5th National Health Services Survey and relevant demographics were retrieved from Health and Family Planning Statistics Yearbook of Shaanxi Province – 2013. Ordinary probit regression model was adopted in data analyses.

  Results  Almost 10% of the patients claimed distrust in outpatient physicians and inpatient physicians and of the 5 038 two-weeks out-patients and the 5 789 yearly in-patients, 22.85% and 31.06% claimed dissatisfaction to the medical service they received and totally about 10% of the medical service utilizers reported the distrust to outpatient clinic doctors and resident doctors. We found an obvious U-shaped relationship between the hospital competition and the patients′ trust on doctors; the utmost intensity of the trust of the outpatients and inpatients were attained when averagely there were 0.942 and 1.009 hospitals for per 1 000 population and the out-pients′ utmost satisfaction toward medical service was attained when there was a 0.829 hospital for 1 000 population.

  Conclusion  A certain extent of hospital competition in Shaanxi province is beneficial to improve patients′ trust to doctors and satisfaction toward medical service but the trust and satisfaction could be reduced with the intensified competition.