Medical escort service demand and service attributes among outpatients based on the Kano model: A cross-sectional study

BACKGROUND: Medical escort services assist outpatients in navigating complex healthcare processes. Although previous studies have examined factors associated with demand for medical escort services among outpatients, evidence remains limited on the classification and prioritization of service attributes. The Kano model is useful for classifying service attributes and prioritizing service improvement. This study applied the Kano model to classify and prioritize service attributes of medical escort services among outpatients. METHODS: A cross-sectional study was conducted in the outpatient departments of a tertiary hospital in Beijing between July and August 2025. Multivariable logistic regression was used to identify factors associated with reported demand for medical escort services. The Kano model and importance-satisfaction analysis were used to categorize service attributes and prioritize areas for improvement. RESULTS: Overall, 61.9% of outpatients reported a demand to use medical escort services. Female patients and those with chronic comorbidities were more likely to report demand, whereas patients aged ≥60 years and unemployed patients were less likely to do so. Among the 17 service items, nine were classified as attractive attributes and eight as one-dimensional attributes. Importance-satisfaction quadrant analysis showed that core process-oriented services were concentrated in high-priority quadrants. Among patients reporting demand for medical escort services, four attributes shifted quadrants relative to the overall sample, indicating different priority patterns. CONCLUSION: Outpatients showed substantial demand for medical escort services, and Kano-based prioritization identified core process-oriented support as central to service delivery. These core services should be delivered reliably. Service design should also be tailored to patient characteristics and reported demand to support patient-centered, resource-efficient program development.