The association between clinicians' legal literacy and the service quality of primary healthcare - evidence from the Greater Bay Area study, China.

BACKGROUND

In healthcare facilities, clinicians' legal literacy may influence the implementation of the law, which is one of the determinants of service quality. Studies regarding the association between clinicians' legal literacy and the quality of services provided by medical facilities were insufficient.

OBJECTIVE

To evaluate the association between clinicians' legal literacy and the quality of primary healthcare services in the Greater Bay Area, China.

METHODS

This study was a cross-sectional design. A general linear model was employed to assess the association between clinicians' legal literacy and the service quality of community health service institutions (CHSIs), controlling for confounding variables. From September 2023 to April 2024, 477 physicians and nurses from 58 CHSIs in the Greater Bay Area, China, engaged in this study. A self-administered questionnaire was utilized to evaluate the clinicians' legal literacy, encompassing legal knowledge, legal attitude, and legal compliance, which was validated by the Delphi method. The National Committee for Quality Assurance Patient-Centered Medical Home (NCQA-PCMH) was employed to assess the service quality of CHSIs.

RESULTS

In the adjusting models, higher scores of legal literacy were related to higher scores of NCQA-PCMH significantly (aβ = 1.360, 95%CI = 0.091-2.630, P = 0.036). Among the six domains of PCMH, PCMH1 (aβ = 0.184, 95%CI = 0.080-0.287, P = 0.001), PCMH3 (aβ = 0.330, 95%CI = 0.052-0.608, P = 0.020), and PCMH4 (aβ = 0.660, 95%CI = 0.256-1.063, P = 0.001) were found to be related to clinicians' legal literacy.

CONCLUSION

This study demonstrated an association between clinicians' legal literacy and the quality of services provided by primary healthcare institutions. The findings offered novel evidence for policymakers and administrators of medical institutions to enhance clinicians' legal literacy with continuing medical education programs, which could improve the overall management framework of contemporary medical facilities.