Mi Jiarun, Du Xinyu, Aili Yilixiati, Li Mingkun, Liu Yuanli
School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, People's Republic of China.
Risk Manag Healthc Policy. 2024 Apr 23;17:1039-1052. doi: 10.2147/RMHP.S456585. eCollection 2024.
Trust is a major factor affecting patient-physician relationship and healthcare quality. However, there has been a lack of comprehensive study on the extent of and major factors affecting patient trust in healthcare providers of China, the world's largest developing country. The objective of this study is to elucidate the current status of outpatient trust in physicians in China and its influencing factors, providing empirical evidence to enhance doctor-patient trust and improve doctor-patient relationships.
Between December 2017 and January 2018, 28,760 patients seeking care at the outpatient departments of 136 tertiary hospitals were interviewed, where they were asked to rate their trust in physicians. We applied a multilevel logistic regression model to explore the association between patients trust and characteristics of hospitals, physicians and patient characteristics. We conducted a series of sensitivity analysis to check the robustness of our findings.
Among 28,760 participants included in this study, 91.54% expressed trust in their physicians, while 7.52% showed moderate trust. Only 0.94% expressly distrusted or strongly distrusted their physicians. Outpatients of hospitals with convenient payment, volunteer guidance and enough seats available in the rest and waiting area showed higher levels of trust. Physicians who had a senior title, showed patience and protection of the patient's privacy were more likely to be trusted by their patients in the outpatient setting. Compared to their female counterparts, male outpatients showed a higher degree of trust.
While this study highlights an overall high level of Trust in physicians (TIP) among patients in China's tertiary hospitals, it is found to vary with patient demographic factors as well as provider's attributes. Hospitals with a more keen sense of protecting patients privacy and better meeting patients' need for efficient and caring service provision process appeared to yield a higher level of trust.
信任是影响医患关系和医疗质量的一个主要因素。然而，对于世界上最大的发展中国家中国，患者对医疗服务提供者信任程度及其主要影响因素，一直缺乏全面的研究。本研究的目的是阐明中国门诊患者对医生信任的现状及其影响因素，为增强医患信任和改善医患关系提供实证依据。
2017年12月至2018年1月期间，对136家三级医院门诊部的28760名就诊患者进行了访谈，询问他们对医生的信任程度。我们应用多水平逻辑回归模型来探讨患者信任与医院、医生特征及患者特征之间的关联。我们进行了一系列敏感性分析以检验研究结果的稳健性。
本研究纳入的28760名参与者中，91.54%表示信任他们的医生，7.52%表示中度信任。只有0.94%明确表示不信任或强烈不信任他们的医生。支付便利、有志愿者引导且休息和候诊区有足够座位的医院的门诊患者表现出更高的信任水平。在门诊环境中，具有高级职称、表现出耐心并保护患者隐私的医生更有可能得到患者的信任。与女性门诊患者相比，男性门诊患者表现出更高程度的信任。
虽然本研究凸显了中国三级医院患者对医生的总体信任水平较高，但发现其因患者人口统计学因素以及医疗服务提供者的属性而异。对保护患者隐私意识更强、能更好满足患者对高效且贴心服务提供过程需求的医院，似乎能产生更高的信任水平。
