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中国的医疗纠纷与患者满意度:医院管理有何重要性?

Medical disputes and patient satisfaction in China: How does hospital management matter?

作者信息

Wang Mengxiao, Liu Gordon Guo-En, Bloom Nicholas, Zhao Hanqing, Butt Thomas, Gao Tianhao, Xu Jiaqi, Jin Xia

机构信息

School of Public Administration, Southwestern University of Finance and Economics, Chengdu, China.

National School of Development, Peking University, Beijing, China.

出版信息

Int J Health Plann Manage. 2022 May;37(3):1327-1339. doi: 10.1002/hpm.3399. Epub 2021 Dec 9.

Abstract

OBJECTIVE

Satisfaction with healthcare may be captured by surveys of patients and staff, or in extreme cases, the number and severity of medical disputes. This study tries to investigate the relationship between satisfaction and hospital management as well as the role of good management in preventing medical disputes ex ante.

METHOD

We investigate this relationship using information on management practices collected from 510 hospitals in mainland China using the World Management Survey questionnaire and combined with medical malpractice litigation data and patient/staff satisfaction surveys. Multiple regression models were used to analyse the relationship between hospital management scores and medical litigation outcomes as well as patient and staff satisfaction during 2014-2016.

RESULTS

An increase of one standard deviation in the management score was related to 13.1% (p < 0.10) lower incidence of medical disputes, 12.4% (p < 0.05) fewer medical litigations, and 51.3% (p < 0.10) less compensation. Better management quality of hospitals was associated with higher inpatient satisfaction (p < 0.05) and staff well-being (p < 0.01).

CONCLUSION

Improving hospital management could reduce hospital costs generated by lawsuits, reduce potential harm to patients, and improve patient and staff satisfaction, thus leading to a better patient-physician relationship.

摘要

目的

对医疗保健的满意度可通过对患者和工作人员的调查来获取,在极端情况下,也可通过医疗纠纷的数量和严重程度来反映。本研究试图调查满意度与医院管理之间的关系,以及良好管理在事前预防医疗纠纷方面的作用。

方法

我们利用通过世界管理调查问卷从中国大陆510家医院收集的管理实践信息,并结合医疗事故诉讼数据以及患者/工作人员满意度调查,来研究这种关系。使用多元回归模型分析2014 - 2016年期间医院管理得分与医疗诉讼结果以及患者和工作人员满意度之间的关系。

结果

管理得分每增加一个标准差,医疗纠纷发生率降低13.1%(p < 0.10),医疗诉讼减少12.4%(p < 0.05),赔偿减少51.3%(p < 0.10)。医院更好的管理质量与更高的住院患者满意度(p < 0.05)和工作人员幸福感(p < 0.01)相关。

结论

改善医院管理可以降低诉讼产生的医院成本,减少对患者的潜在伤害,提高患者和工作人员满意度,从而带来更好的医患关系。

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