Liu Zifeng, Zhang Yong, Asante Joseph Obiri, Huang Yixiang, Wang Xin, Chen Lijin
Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangzhou, Guangdong, China.
Guangdong Provincial Key Laboratory of Stomatology, Sun Yet-sen University, Guangzhou, Guangdong, China.
BMJ Open. 2018 Feb 8;8(2):e018738. doi: 10.1136/bmjopen-2017-018738.
Doctor-patient conflict is a phenomenon that has become one of the major social problems affecting China's medical system today. This study aimed to analyse the nature of medical dispute incidents arising from dental practice, discover the related factors that may have incited such disputes and explore measures whereby the incidents of patients' conflicts towards dentists can be reduced.
A survey conducted in six public hospitals in Guangzhou, one of the largest cities in China, showed that more than two million patients received dental treatment between 2008 and 2012. χ test and binary logistic regression analysis were used to identify statistically significant differences in incident rates.
In a total of more than two million outpatients, 541 reported dental disputes and lodged complaints with the medical service centre. Male patients reported higher dispute rates than did females (χ=9.74, P<0.01). Binary logistic regression analysis further showed that disputes developed into conflicts depending on five factors: patient gender, dental specialty, cause of dispute, mode of payment and resolution duration.
Gender, specialties, cause of dispute, mode of payment and resolution duration are associated with the incidence of dental conflicts, suggesting that medical quality is positively correlated to dental disputes, the coverage of stomatology in medical insurance should be expanded and detailed negotiation system should be developed for resolving dental disputes.
医患冲突是一种已成为影响当今中国医疗体系的主要社会问题之一的现象。本研究旨在分析牙科医疗纠纷事件的性质,找出可能引发此类纠纷的相关因素,并探索减少患者与牙医冲突事件的措施。
在中国最大城市之一广州的六家公立医院进行的一项调查显示,2008年至2012年期间有超过200万患者接受了牙科治疗。采用χ检验和二元逻辑回归分析来确定事件发生率的统计学显著差异。
在总共超过200万门诊患者中,有541人报告了牙科纠纷并向医疗服务中心投诉。男性患者报告的纠纷率高于女性(χ=9.74,P<0.01)。二元逻辑回归分析进一步表明,纠纷是否演变为冲突取决于五个因素:患者性别、牙科专科、纠纷原因、支付方式和解决时长。
性别、专科、纠纷原因、支付方式和解决时长与牙科冲突的发生率相关,这表明医疗质量与牙科纠纷呈正相关,应扩大医疗保险中口腔医学的覆盖范围,并建立详细的协商系统来解决牙科纠纷。