Analysis of current situation and influencing factor of medical disputes among different levels of medical institutions based on the game theory in Xiamen of China

Abstract

With continuous development of the Chinese health care system, the doctor–patient relationship is increasingly tense in recent years. China has witnessed a surge in medical disputes, including many widely reported violent riots, attacks, and protests in hospitals. This study aimed to help to theorize the doctor–patient relationship based on the game theory, and analyze the current situation and influencing factors for medical disputes among different hospitalsA total of 17 hospitals were randomly selected in Xiamen city, including 8 tertiary hospitals and 9 secondary hospitals. All medical dispute cases, between 2012 and 2014, were collected through questionnaires. Multiple logistic regression analyses were used to identify risk factors associated with medical disputes.In total, 896 medical dispute cases happened in 2012 to 2014, 733 (81.8%) of which occurred in tertiary hospitals. Medical disputes mainly were reported in the departments of obstetrics and gynecology (24.9%). The main causation of medical disputes was improper communication (24.0%) in tertiary hospitals and lower therapeutic skills (43.7%) in secondary hospitals, respectively. The negotiated rate (91.4%) in secondary hospitals was significantly higher than the tertiary hospitals (54.8%). The patients’ age, occupation and the doctor's medical location, professional title were the main risk factors for the occurrence of medical violence.Relationships between doctors and patients have become worse increasingly, whereas doctor–patient disputes or conflicts and their compensation have aggrandized year by year. The game relationship of doctor–patient is noncooperation, dynamic, and incomplete information game, and the advantages of cooperation are far greater than the competition between doctors and patients. Therefore, we need to take targeted measures to prevent and control the medical disputes by establishing a harmonious doctor–patient relationship in different levels of medical institutions.

Workplace violence and its aftermath in China’s health sector: implications from a cross-sectional survey across three tiers of the health system

“…The prominent problem of WPV in China is believed to be related to systemic and historical factors 14 15. Insufficient public funding into the public health sector, commercialisation of public health facilities, and high out-of-pocket payment contributed to patient dissatisfaction with public health services over time, leading to a distrust of healthcare professionals and poor doctor-patient relationships 16.…”

A Systematic Review of the Health Worker-Patient Relationship in China

“…Moreover, the reimbursement rate and range of medical insurance coverage may also affect the HWPR [78]. Therefore, the establishment of a sound medical insurance system, to a certain extent, would ease patient burdens and improve the HWPR [32,44].…”

“…Mutual trust between health workers and patients could construct a favourable atmosphere for the HWPR. Substantial previous studies from Norway [45], Singapore [79], America [46], the Netherlands [80], Australia [81] and China [32,78] argued that trust played a crucial role in fostering a win-win HWPR. Second, effective communication could promote rapport between health workers and patients.…”

“…Previous studies have explored the effects of various factors on the HWPR, such as health worker-related factors (i.e., age [13][14][15][16][17][18][19], gender [19][20][21][22][23][24][25], years of experience [26,27], education level [28][29][30], ethnicity [30], marital status [29], professional title [31,32], department [13,33,34], income [30,35,36], income satisfaction [30,37,38], etc. ), patient-related factors (i.e., age [29,30,36], gender [29,30,36], residence [39][40][41], ethnicity [30], education level [42,43], medical insurance [32,44], medical expense [44], household income [30], waiting time...…”

Headache in the emergency department in Chongqing Province, China: A multicentre study

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