A Study On The Quality Of The Influencing Factors Of Patient Complaints

The doctor-patient relationship in China was not optimistic.The contradictions between doctors and patients were prominent,and the number of patients’ complaints were still high.Complaints represented dissatisfied medical experience of patients or demands in complex situations,which was a rational and multi-factor behavioral process.To insight into the influence factors of patient complaints behavior and find the problems existing in the hospital,this study conducted a qualitative study on the patients with complaint experience and the internal complaint handling staff of X Hospital in Shandong Province by analyzing the complaint text records.On the one hand,it is beneficial to improve the current situation of complaint management,enhance the quality of medical service and ease the tension between doctors and patients to comprehensively view the influencing factors of patients’ complaint behavior from the perspective of patients.On the other hand,from the perspective of the hospital,it could put forward the relevant suggestions to solve the complaint problem,and it provided effective reference for improve the hospital service quality,alleviate the conflict between doctors and patients.Regarding to relevant models in the field of customer complaints,this study conducted a semi-structured in-depth interview with 21 patients with complaint experience and 4 staff engaged in complaint handling from August to December 2021,using a descriptive property research method,purpose sampling and theoretical sampling After transcribing and subject analysis the interview text,the results were summarized.Meanwhile,according to the Healthcare Analysis Tool,the text records of 1058 complaints in Shandong X Hospital from 2019 to 2020 were analyzed by content analysis method to describe the current situation of complaints,hot spots of complaints and critical fault points.The results showed that 4 themes and 11 sub-themes were summarized by extraction and summary coding.The 4 themes contained hospital factors,personal characteristics,situational factors,and social environment factors,among which,hospital factors accounted for the most frequency,up to 40%.Among the 11 sub-themes,hospital factors included medical quality,medical management,and medical relationship;Personal factors included attitude towards complaints and other personal characteristics;Situational factors included complaint cost,the likelihood of success,degree of physical injury,and emotion of the sufferer;Social environmental factors included the advancement of ideas and a favorable supportive environment.Eliminated unqualified complaint records,and finally identified 1066 valid complaint records(one text can contain more than one complaint record).More than half(53.8%)of the complainants were patients,and nearly half(47.1%)of the complainants were doctors.The complaint areas mainly included relationship areas(communication and care),management areas(institutional issues,waiting time and service accessibility),and clinical areas(medical quality and medical safety),accounting for 47.1%,37.5%,and 15.4%,respectively.Most of the complaints were mild(71.3%),43.3%of the complaints occurred in the examination and diagnosis stage,and the vast majority of the complaints(92.9%)did not cause harm to patients.As for the hot spots of complaints,relationship problems mainly appeared in the examination and diagnosis stage,while management problems mainly appeared in the admission and discharge stage.Clinical problems mainly emerged at the treatment stage.The critical failure points mainly included the quality of treatment,the waiting time of admission and the service accessibility.The complaint is a rational and multi-factor action process.The influencing factors of patients’ complaint behaviors were found in individual interviews,and specific problems existing in hospitals were found in detailed records of complaint texts.From the perspective of the hospital,this study put forward the following suggestions for improvement:1)Strengthening the supervision and management of the hospital,enhancing the sense of responsibility,standardizing the diagnosis and treatment behavior,and improving the quality of medical service;2)Improving the medical management system,optimizing the discharge and admission process,strengthening the management of the complaint handling department,improving the establishment of the complaint department,clarifying the responsibilities of each department and standardizing the complaint handling;3)Constructing a "patient-centered"cultural atmosphere,and constantly improving the humanistic care of medical staff.