Journal article
Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China
PloS one, Vol.12(7), pp.e0181396-e0181396
2017
DOI: 10.1371/journal.pone.0181396
PMCID: PMC5533441
PMID: 28753619
Abstract
To provide an empirical examination of patient-provider relationships (PPR) and its association with organizational and individual factors.
A national cross-sectional survey was conducted by stratified cluster sampling in 77 hospitals across seven provinces in China between July 2014 and April 2015, involving 3621 doctors, 5561 nurses, and 8022 patients with response rates of 62.93%, 61.16%, and 33.08%, respectively. Self-perceived PPR was the outcome variable. Organizational factors included hospital type (western medicine [WM] and traditional Chinese medicine [TCM] hospital); hospital level (tertiary and secondary hospital); area of specialization (internal medicine and surgery); ratio of doctors (nurses) to ward beds; doctors/nurses' concerns about performance assessment; and patients' perceptions of healthcare cost. Individual factors included consultation, listening to patients and socio-demographic factors.
54.6% of doctors, 36.6% of nurses, and 10.2% of patients perceived PPR as poor. Organizational factors independently associated with providers' perception of poor PPR included hospital type (WM vs TCM: OR = 1.25 [95% CI: 1.06-1.47]) and concerns about performance assessment (high vs low levels: OR = 1.40 [95% CI: 1.14-1.72]) for doctors, and concerns about performance assessment (average vs low levels: OR = 0.79 [95% CI: 0.67-0.93]) for nurses. Those associated with patients' perception of poor PPR included hospital type (WM vs TCM: OR = 0.63 [95% CI: 0.53-0.74]) and hospital level (tertiary vs secondary: OR = 0.65 [95% CI: 0.51-0.82]). Doctors and nurses reporting listening to patients "frequently" had better perceptions of PPR (OR = 0.46 [95%CI: 0.38-0.56] and 0.49 [95% CI: 0.41-0.59] for doctors and nurses, respectively), as did their patients (OR = 0.24 [95% CI: 0.18-0.31] and 0.54 [95% CI: 0.35-0.84] for doctors and nurses, respectively).
Although our findings require validation in different organizational settings given the likely variability of these associations across systems, our results suggest that implementing moderate levels promoting the level of medical treatment, and broadening doctors/nurses training regarding listening to patients, may benefit to enhance PPR.
Details
- Title: Subtitle
- Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China
- Creators
- Ping Zhang - Huazhong University of Science and TechnologyFang Wang - Huazhong University of Science and TechnologyYao Cheng - Huazhong University of Science and TechnologyLiu Yi Zhang - Huazhong University of Science and TechnologyBei Zhu Ye - Huazhong University of Science and TechnologyHong Wei Jiang - Huazhong University of Science and TechnologyYi Sun - Huazhong University of Science and TechnologyXi Zhu - University of IowaYuan Liang - Huazhong University of Science and Technology
- Resource Type
- Journal article
- Publication Details
- PloS one, Vol.12(7), pp.e0181396-e0181396
- DOI
- 10.1371/journal.pone.0181396
- PMID
- 28753619
- PMCID
- PMC5533441
- NLM abbreviation
- PLoS One
- ISSN
- 1932-6203
- eISSN
- 1932-6203
- Grant note
- DOI: 10.13039/501100001809, name: National Natural Science Foundation of China, award: 71273098
- Language
- English
- Date published
- 2017
- Academic Unit
- Health Management and Policy
- Record Identifier
- 9984363608002771
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