Thi Thu Ha Bui, Mirzoev Tolib, Morgan Rosemary
Hanoi School of Public Health, Hanoi, Vietnam.
Nuffield Centre for International Health and Development, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK.
SAGE Open Med. 2015 Oct 9;3:2050312115610127. doi: 10.1177/2050312115610127. eCollection 2015.
There is growing recognition of patient rights in health sectors around the world. Patients' right to complain in hospitals, often visible in legislative and regulatory protocols, can be an important information source for service quality improvement and achievement of better health outcomes. However, empirical evidence on complaint processes is scarce, particularly in the developing countries. To contribute in addressing this gap, we investigated patients' complaint handling processes and the main influences on their implementation in public hospitals in Vietnam.
The study was conducted in two provinces of Vietnam. We focused specifically on the implementation of the Law on Complaints and Denunciations and the Ministry of Health regulation on resolving complaints in the health sector. The data were collected using document review and in-depth interviews with key respondents. Framework approach was used for data analysis, guided by a conceptual framework and aided by qualitative data analysis software.
Five steps of complaint handling were implemented, which varied in practice between the provinces. Four groups of factors influenced the procedures: (1) insufficient investment in complaint handling procedures; (2) limited monitoring of complaint processes; (3) patients' low awareness of, and perceived lack of power to change, complaint procedures and (4) autonomization pressures on local health facilities. While the existence of complaint handling processes is evident in the health system in Vietnam, their utilization was often limited. Different factors which constrained the implementation and use of complaint regulations included health system-related issues as well as social and cultural influences.
The study aimed to contribute to improved understanding of complaint handling processes and the key factors influencing these processes in public hospitals in Vietnam. Specific policy implications for improving these processes were proposed, which include improving accountability of service providers and better utilization of information on complaints.
全球卫生部门对患者权利的认识日益提高。患者在医院的投诉权，在立法和监管协议中经常可见，它可以成为服务质量改善和实现更好健康结果的重要信息来源。然而，关于投诉流程的实证证据很少，特别是在发展中国家。为了填补这一空白，我们调查了越南公立医院患者的投诉处理流程及其实施的主要影响因素。
该研究在越南的两个省份进行。我们特别关注《投诉与检举法》以及卫生部关于卫生部门投诉解决的规定的实施情况。数据通过文件审查和对关键受访者的深入访谈收集。采用框架方法进行数据分析，以概念框架为指导，并借助定性数据分析软件。
实施了投诉处理的五个步骤，不同省份在实践中存在差异。有四类因素影响了这些程序：（1）对投诉处理程序的投资不足；（2）对投诉流程的监督有限；（3）患者对投诉程序的认识低，且认为自己没有改变投诉程序的权力；（4）地方卫生机构面临的自主化压力。虽然越南卫生系统中投诉处理流程的存在是明显的，但其利用率往往有限。制约投诉规定实施和使用的不同因素包括与卫生系统相关的问题以及社会和文化影响。
该研究旨在促进对越南公立医院投诉处理流程以及影响这些流程的关键因素的更好理解。提出了改善这些流程的具体政策建议，包括提高服务提供者的问责制和更好地利用投诉信息。
