Why Patients with Chronic Disease Keep Silent? Analysis of Item Nonresponse in Rural China

This study aimed to identify the characteristics of item nonresponse and examine the factors affecting the refusal or failure to respond of patients with chronic disease in rural China. A cross-sectional survey data from patients with chronic disease from rural China were analyzed. A total of 1,099 patients were enrolled. Chi-square test and cumulative logistic regression determined the predictors of having item nonresponse. The respondents in central provinces (OR = 2.311, 95%CI = 0.532~1.144, P < 0.001) with over eight household members (OR = 0.067, 95%CI = -1.632~-0.349, P = 0.002), multiple chronic diseases (OR = 0.301, 95%CI = -1.673~-0.727, P < 0.001), and low health knowledge level (OR = 2.112, 95%CI = 0.405~1.090, P < 0.001) had more item nonresponse numbers. Compared with the participants with high school education level and above, the item nonresponse number seemed to increase when the participants were illiterate (OR = 2.159, 95%CI = 0.254~1.285, P = 0.003), had primary school education (OR = 2.161, 95%CI = 0.249~1.294, P = 0.004) and junior school education (OR = 2.070, 95%CI = 0.160~1.296, P = 0.012). This study indicates the influencing factors of the item nonresponse in survey of patients with chronic disease in rural China. This study contributes to investigation practice and highlights that health institutions should improve the quality of follow-up services. Moreover, the government should pay more attention to the care of vulnerable groups, especially patients with chronic disease in rural areas.