Investigation On Status And It's Determinants Of Relationship Between Doctors And Patients In Hengyang City

BackgroundGenerally speaking the doctor-patient relationship in our country is harmonious with parts of disharmonious factors, however, harmony is the mainstream, and disharmony is a tributary. The doctor -patient relationship also presents an unprecedented state of tension. It plays an important role to build harmonious society of creating the new modern harmonious and unified of doctor-patient relationship. The harmonious doctor-patient relationship has been a hot topic, since the ministry of health and the state administration of traditional Chinese medicine carried out the hospital management year in the theme of"patient-centered principle and total quality improvement"in all kinds of movement in 2005, Therefore, the research on the construction of a harmonious relationship, investigate the influence factors and proposed the policy and suggestion between doctors and patients has a positive and practical significance.ObjectiveTo understand the doctor-patient relationship status of Hengyang, explore the factors of doctor-patient relationship nervous, and bring forward the countermeasures and suggestions of constructing harmonious doctor-patient relationship, to mitigate the doctor-patient conflicts.MethodsBy stratified cluster sampling method, check three different grades hospital randomly, according to the grades of the hospital, randomly a certain proportion of doctors and patients to questionnaire survey, investigation contents include the doctor-patient relationship status and influencing factors, and how to constructing harmonious doctor-patient relationship.Results1. Nervousness degree and influencing factors of the doctor-patient relationship(1) 71.0% medical staff and 59.3% patients considered that doctor-patient relationship is nervous; the doctor-patient relationship in the public hospital is the worst in three different grades hospital. In different grade hospital, the evaluation of doctor-patient relationship nervous is different(P<0.05), medical workers consider the doctor-patient relationship is more nervous than patient(P<0.01).(2) To cause the doctor-patient relationship nervous, Doctors and patients has different views(P<0.01); medical personnel considered that"medical costs too expensive"is the main reasons which cause the doctor-patient relationship nervous, secondly is"patients difficulties in getting medical"; patient considered that"bad service attitudes"is the main reasons, and"medical costs too expensive"is the second reasons.(3).Most of the medical staffs considered that the cause of the current tension between the patients and doctors is attributed to patients, while majority of the patients consider it to be unclear. So the medical staff and patients hold different views on the responsibility of tension between doctors and patients (P <0.05 ), but any level hospitals do not consider they primarily are responsible for the tension (P <0.01).2. Problems in medical ethics and improvement(1)In different grade hospital, doctors considered that question in medical ethics is different(P<0.01), but no difference in patients(P>0.05),"abuse much more assay"is the most prominent problems in Public hospital medical staff; ethics evaluation of the most prominent problems appraisal existence difference in Grade Three A Hospital doctor-patient(P<0.01). Generally speaking,"abuse much more assay"is the most prominent problems in doctors and patients.(2) The medical staffs and patients at all levels hold different views on the content needed to improved in medical ethics (P<0.05).The hospital think that the responsibility of medical staffs is needed to strengthened in particular; while the patients think that of those who consider that reduce expenditure is more important.3. Satisfaction of the communication between doctor-patient , reasons for the difficulties of communication and the improved way(1) Medical staffs in the hospitals at all levels consider there is no difference in the satisfaction rate of communication between doctors and patients (P> 0.05), which is of over 20%; but the patients consider there is difference in the satisfaction rate of communication between doctors and patients (P <0.05). The highest satisfaction rate of communication between doctors and patients comes from private hospitals, which the lowest comes from the Grade Three A Hospital .In general, the satisfaction of communication from patients is lower than the evaluation of medical. (2) Medical staffs and patients in the hospitals at all levels hold different views on the cognition of reasons on the difficulty of communication between doctors and patients (P <0.01).The medical side think the main reason comes to the different levels of education (35.1%) ,which the patients think that belongs to different status of doctors and patients(30.7%).(3) The doctors think that the primary way to improve physician-patient relationship is strengthening accountability of doctors (51.5%); while the patients consider an effective way to improve physician-patient relationship is to reduce the cost of health care ,followed by "efforts to strengthen Medicare. "4. Objectivity of media report and the effects of doctor-patient relationship(1) In public hospitals, 60% medical staff think that media report is not objective, higher than private hospitals(36.9%); objective evaluation of media report was no difference which patients in the hospitals at all levels(P>0.05), But still about 25% patients think that media report is not too objective, about 55% patients thinks that media report is more objective.(2) 59.1% medical staff think that media report goes against construction of harmonious doctor-patient relationship, 24.6% medical staff think that media report is favorable to construce of harmonious doctor-patient relationship; 57.0%patients think that media report is favorable to construce of harmonious doctor-patient relationship.Conclusions1 The doctor-patient relationship tends to be instensive tensions at present, most of the medical personnel consider that"medical costs too expensive"is the main reasons which cause the doctor-patient relationship nervous, and patients consider"bad service attitudes"and"medical costs too expensive"are the main reasons, most medical personnel considered that responsibility to cause the doctor-patient relationship nervous is cause of patients, and patients view is not clear.2 Doctors and patients both thought the most prominent medical ethics is"abuse much more assay", doctors considered that need to be improved are"strengthen sense of doctor's responsibility", While patients considered the most need to be improved are"save costs, reduce costs".3 The situation of doctor-patient communication is not optimistic, most of doctors considered that"different education level"is the main reasons of doctor-patient communication difficulties, and patients considered that"different status"is the main reasons. Although most of doctors considered that strengthen sense of responsibility are the primary way of improving the doctor-patient relationship, but most of patients thinks that reduce medical treatment cost is the primary way.4 Most of the doctors think that media report is not too objective, and goes against construce of harmonious doctor-patient relationship; most of the patients thinks that media report is objective, and be beneficial to the constructing harmonious doctor-patient relationship.