不满意的患者各有不同:对中国好医生网站负面评论的内容分析
Unhappy Patients Are Not Alike: Content Analysis of the Negative Comments from China's Good Doctor Website.
作者信息
Zhang Wei, Deng Zhaohua, Hong Ziying, Evans Richard, Ma Jingdong, Zhang Hui
机构信息
Institute of Smart Health, School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan, China.
Department of Business Information Management and Operations, University of Westminster, London, United Kingdom.
出版信息
J Med Internet Res. 2018 Jan 25;20(1):e35. doi: 10.2196/jmir.8223.
BACKGROUND
With the rise in popularity of Web 2.0 technologies, the sharing of patient experiences about physicians on online forums and medical websites has become a common practice. However, negative comments posted by patients are considered to be more influential by other patients and physicians than those that are satisfactory.
OBJECTIVE
The aim of this study was to analyze negative comments posted online about physicians and to identify possible solutions to improve patient satisfaction, as well as their relationship with physicians.
METHODS
A Java-based program was developed to collect patient comments on the Good Doctor website, one of the most popular online health communities in China. A total of 3012 negative comments concerning 1029 physicians (mean 2.93 [SD 4.14]) from 5 highly ranked hospitals in Beijing were extracted for content analysis. An initial coding framework was constructed with 2 research assistants involved in the codification.
RESULTS
Analysis, based on the collected 3012 negative comments, revealed that unhappy patients are not alike and that their complaints cover a wide range of issues experienced throughout the whole process of medical consultation. Among them, physicians in Obstetrics and Gynecology (606/3012, 20.12%; P=.001) and Internal Medicine (487/3012, 16.17%; P=.80) received the most negative comments. For negative comments per physician, Dermatology and Sexually Transmitted Diseases (mean 5.72, P<.001) and Andrology (mean 5, P=.02) ranked the highest. Complaints relating to insufficient medical consultation duration (577/3012, 19.16%), physician impatience (527/3012, 17.50%), and perceived poor therapeutic effect (370/3012, 12.28%) received the highest number of negative comments. Specific groups of people, such as those accompanying older patients or children, traveling patients, or very important person registrants, were shown to demonstrate little tolerance for poor medical service.
CONCLUSIONS
Analysis of online patient complaints provides an innovative approach to understand factors associated with patient dissatisfaction. The outcomes of this study could be of benefit to hospitals or physicians seeking to improve their delivery of patient-centered services. Patients are expected to be more understanding of overloaded physicians' workloads, which are impacted by China's stretched medical resources, as efforts are made to build more harmonious physician-patient relationships.
背景
随着Web 2.0技术的日益普及,患者在在线论坛和医疗网站上分享对医生的体验已成为一种常见做法。然而,患者发布的负面评论被其他患者和医生认为比满意评论更具影响力。
目的
本研究旨在分析在线发布的关于医生的负面评论,并确定提高患者满意度的可能解决方案,以及它们与医生的关系。
方法
开发了一个基于Java的程序,用于收集中国最受欢迎的在线健康社区之一好大夫在线网站上的患者评论。从北京5家排名靠前的医院提取了总共3012条关于1029名医生(平均2.93 [标准差4.14])的负面评论进行内容分析。构建了一个初始编码框架,有2名研究助理参与编码。
结果
基于收集到的3012条负面评论进行分析,结果显示不满意的患者各有不同,他们的投诉涵盖了整个医疗咨询过程中遇到的广泛问题。其中,妇产科医生(606/3012,20.12%;P = 0.001)和内科医生(487/3012,16.17%;P = 0.80)收到的负面评论最多。就每位医生的负面评论而言,皮肤科与性病科(平均5.72,P < 0.001)和男科(平均5,P = 0.02)排名最高。与医疗咨询时间不足(577/3012,19.16%)、医生不耐烦(527/3012,17.50%)以及认为治疗效果不佳(370/3012,12.28%)相关的投诉收到的负面评论最多。特定人群,如陪同老年患者或儿童的人、就诊患者或重要人物挂号者,对不良医疗服务的容忍度较低。
结论
对在线患者投诉的分析提供了一种创新方法,以了解与患者不满相关的因素。本研究结果可能有助于寻求改善以患者为中心服务的医院或医生。随着努力构建更和谐的医患关系,预计患者会更理解因中国医疗资源紧张而负担过重的医生工作量。
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