Abstract: Objective To examine hospitalization satisfaction and its related factors among rural inpatients in county and towship hospitals and to provide reference for improving medical service of the hospitals.Methods Totally 486 patients from county hospitals and 421 from township hospitals were selected with stratified cluster random sampling to conduct a hospitalization satisfaction survey in Ju county,Yiyuan county and Qufu county in Shandong province.Results The overall satisfaction to medical service of township hospitals and county hospitals were 3.37±0.70 and 3.18±0.65,and the overall satisfaction to township hospitals was lower than to county hospitals(P<0.01).The township hospitals also had lower scores than the county hospitals in the inpatients satisfaction to environment(3.41±0.61 vs 3.69±0.68),service process(3.47±0.60 vs 3.81±0.61),and treatment outcome(3.57±0.60 vs 3.75±0.62)(P<0.01 for all).However,the township hospitals had higher scores than the county hospitals in the inpatients' satisfaction to medical expenses(3.92±0.60 vs 3.19±0.70)(P<0.01).There were no significant differences in the inpatients satisfaction to disease explaination,service attitude between county and township hospitals.Age,total expense,amount of personalpayment,length of stay were negatively correlated with inpatients' overall satisfaction for both county and township hospitals.However,educational achievement,per capita family income,and the institutional capacity were positively correlated with the inpationts' overall satisfaction for hospitals at both county and township levels.Conclusion Strengthening the township hospitals' capacity building and reducing the medical costs of inpatients of county hospitals are the priority measures to improve the rural inpatients' hospitalization satisfaction.