| ObjectiveThe 14th Five-Year Plan for Universal Medical Security emphasizes deepening the reform of the medical and health system,optimizing the collaborative governance system of medical security,and building a harmonious doctor-patient relationship.However,in recent years,disputes between doctors and patients have occurred frequently in China,and the current situation of doctor-patient relations is not optimistic.The medical security system,as an important factor affecting the doctor-patient relationship,also causes disputes that undermine the harmonious relationship between the three parties of"doctor-patient insurance",which is not conducive to building a trust bridge between all parties.This study clarifies the concept of medical insurance doctor-patient disputes through a review of domestic and foreign literature,deeply explores the status,causes and preventive measures of medical insurance doctor-patient disputes,and provides suggestions for promoting the in-depth reform of the medical security system.Method(1)Quantitative research.Data were collected through a questionnaire.A total of 220medical workers were selected from the secondary and tertiary hospitals in Taiyuan(sample effective rate:96%);A total of 220 patients and their families(sample effective rate 95%)were selected and SPSS 26.0 was used for statistical analysis to research the current situation of medical insurance research doctor-patient disputes.(2)Qualitative research.Participants were interviewed through semi-structured interviews.The interview participants were medical workers,patients and family members who had received questionnaire surveys and had experience in disputes,and a total of 50text materials were obtained.Nvivo12 was used to organize and analyze the text data,and construct the influencing factor model of such disputes.ResultBy analyzing the data obtained from the questionnaire,the authors obtained the current status of medical insurance doctor-patient disputes.The incidence of medical insurance doctor-patient disputes is different in different levels of hospitals(χ~2=4.623,p<0.05).The incidence of disputes in the medical group is greater than that in the patient group(χ~2=7.362,p<0.01).The perception of the doctor-patient relationship between the doctor and the patient is negative(χ~2=31.174,p<0.01).Doctors and patients have different perceptions of the factors influencing disputes.Doctor-patient disputes affect patients’satisfaction with medical treatment and at the same time affect doctors’job satisfaction.(The differences in working environment,intensity,salary level,respect and recognition,and satisfaction scores of career development opportunities in the medical group are statistically significant,p<0.01,and the difference in medical insurance reimbursement ratio and medical workers’service attitude of the patient group is statistically significant,p<0.05).ConclusionThe reasons for such disputes include inconsistent regional policies,inadequate policy publicity,difficulty in implementing the directory,unsmooth two-way referral,and insufficient departmental communication.The core influencing factors of medical insurance doctor-patient disputes include political and social environment,hospital and medical environment,medical workers,and patient groups.Based on the core influencing factors obtained from the research,combined with interview results and relevant literature,strategies to prevent such disputes are proposed.The government establishes a communication mechanism for the supervision of medical institutions,strengthens the effective implementation and promotion of policies;Hospitals attach great importance to the entire process management of medical insurance and improve the comprehensive performance evaluation system;Medical workers should improve their service level and strengthen their policy mastery;Patients active learning the medical insurance policy,change the idea of seeking medical care,and become the builders of"a community of shared future for doctors and patients". |
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