Items:

Unawareness
1. I usually don’t know enough about my health to decide if I should go to the doctor.
2. I am usually worried that I will be diagnosed with a major illness when I go to the doctor.
3. I am usually unclear about which hospital, department or doctor I should choose based on my symptoms.
4. I am usually unable to understand the doctor’s terminology.
5. After the consultation, I usually do not understand my condition and do not know whether I need further treatment.
6. I usually do not understand the health insurance policies (e.g. reimbursement level, scope of reimbursement, etc.).

Unavailability
1. I usually feel that there are not enough hospitals in my city.
2. I usually feel that hospitals in my city do not have enough doctors, nurses and other staff.
3. I usually feel that the number of hospital facilities or equipment in my city is insufficient (e.g., lack of beds, ultrasound machines, etc.).
4. I usually feel that in my city, there are not enough hospitals or doctors with high quality and good standards of care.
5. I usually feel that the type of treatment I want (e.g., Chinese medicine, oncology, etc.) is not available in my city.

Inaccessibility
1. I usually feel that I live too far from a hospital.
2. I usually feel that there is no suitable transportation to the hospital.
3. I usually feel that the traveling time to the hospital is too long.
4. I usually find it inconvenient to travel to the hospital (e.g. I need to be accompanied by my family, or I have mobility problems).

Inadaptability
1. I usually find the layout of the hospital floors, departments, etc. not well organized and the signage is not clear.
2. I usually feel that the service provided by the hospital is not good (e.g. inconvenient to return to the clinic, duplicate registration, no medical guide, etc.).
3. I usually feel that the service time provided by doctors is not sufficient to meet my consultation needs.
4. I usually have to wait a long time (for registration, tests, medication dispensing, etc.) to see a doctor.
5. I usually find the process of getting reimbursed or receiving benefits cumbersome.

Unaffordability
1. Before the visit, I usually feel that the medical cost is too expensive.
2. At the time of the visit, I usually feel that my family’s and my ability to pay is not enough to cover the full cost of care.
3. After the visit, my family and I usually still have a heavy financial burden after insurance reimbursement (if available).
4. My family and I usually cannot afford the additional costs (e.g. travel and transportation, professional care, lost income, etc.) that come with a doctor’s visit.

Unacceptability
1. I usually have a feeling of distrust in the skill level of doctors.
2. I usually feel that the doctor will prescribe unnecessary tests or medicines.
3. I usually feel reluctant to go to a doctor with whom I am not familiar.
4. I usually feel worried about catching other diseases in the hospital.
5. I usually feel that my doctor treats me badly.
6. I am usually concerned about the treatment options (e.g., medication, tests) offered by my doctor (e.g., worried about side effects, pain, etc.).
7. I usually feel that I am not treated with respect when I visit the hospital.