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公众对医生的信任:影响中国患者对医生信任度的患者相关因素的实证分析。

Public trust in physicians: empirical analysis of patient-related factors affecting trust in physicians in China.

机构信息

Department of Health Economics, School of Health Management, Inner Mongolia Medical University, Hohhot, China.

Department of Health Policy and Management, College of Public Health, University of Georgia, 100 Foster Rd, Wright Hall 116, Athens, GA, 30602, USA.

出版信息

BMC Prim Care. 2022 Aug 30;23(1):217. doi: 10.1186/s12875-022-01832-6.

Abstract

BACKGROUND

Trust between the parties is essential for the efficient functioning of the healthcare market. Physician-patient relationship represents an asymmetric information situation and trust in physicians is critical for improving health and wellbeing of patients. In China, trust in physicians appears to be quite low creating conflicts between physicians and patients. This study aims to identify some general factors associated with trust in physicians in general using a nationally representative survey.

METHODS

A cross-sectional analysis using data from 2018 China Family Panel Study (CFPS). Survey responses of individuals aged 16 years or above were extracted from CFPS and the final sample consisted of 29,192 individuals. An ordered probit model was used to identify factors causing heterogeneity in the levels of trust in physicians.

RESULTS

Higher educational attainment and having medical insurance coverage are associated with higher likelihood of trusting physicians. Older adults (> = 30 years), males, urban residents, wage-earners, and self-employed persons are less likely to trust physicians. People who are diagnosed as chronic diseases or current smokers indicate lower level of trust in physicians. Higher perceived quality of services improves trust.

CONCLUSION

Socioeconomically disadvantaged population groups and uninsured individuals are less likely to trust physicians. Health care delivery system needs to address the concerns of these specific population groups to reduce tensions between physicians and patients. Increasing health insurance coverage and offering insurance with low out-of-pocket expenses should reduce the perception that physicians are more guided by their income rather than the wellbeing of patients. The system should also develop a comprehensive bill of rights of patients to improve patient-physician relationship.

摘要

背景

医患双方之间的信任是医疗市场有效运作的关键。医患关系代表了一种信息不对称的情况,对医生的信任对于改善患者的健康和福祉至关重要。在中国,医生的信任度似乎很低,导致医患之间产生冲突。本研究旨在使用具有全国代表性的调查来确定一些与普遍信任医生相关的一般因素。

方法

使用 2018 年中国家庭追踪调查(CFPS)的数据进行横断面分析。从 CFPS 中提取年龄在 16 岁及以上的个人的调查回复,最终样本由 29192 人组成。使用有序概率模型来确定导致信任医生水平异质性的因素。

结果

较高的教育程度和医疗保险覆盖与更有可能信任医生相关。年龄较大(≥30 岁)、男性、城市居民、工薪阶层和自雇人士不太可能信任医生。被诊断为慢性病或当前吸烟者的人对医生的信任度较低。较高的服务质量感知会提高信任度。

结论

社会经济地位较低的人群和没有保险的人不太可能信任医生。医疗保健提供系统需要解决这些特定人群的问题,以减少医患之间的紧张关系。增加医疗保险覆盖范围并提供低自付费用的保险,应减少认为医生更多地受其收入而不是患者的福祉指导的看法。该系统还应制定患者全面的权利法案,以改善医患关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baee/9429628/d52563e73394/12875_2022_1832_Fig1_HTML.jpg

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