Study On The Interaction Mechanism Of Mutual Influence Between Doctor-patient Trust And Medical Service Quality Based On Patient's Perspective

At present,under the condition of China's market economy,the structure of social trust in China shows the weakening of traditional trust and the relative deficiency of modern trust.In the health industry,the main manifestation is the mutual distrust between doctors and patients,resulting in conflicts between doctors and patients,which have a great social impact and even harm medical personnel every year.Among them,the deep reason for the deterioration of doctor-patient relationship is the mutual distrust between doctors and patients.The lack of mutual trust between doctors and patients seriously affects the quality of medical services,and the poor quality of medical services leads to the deterioration of the trust between doctors and patients,forming a vicious circle.Based on the above understanding,the government has introduced a series of policies to build a harmonious doctor-patient relationship and improve the quality of medical services.However,the problems of mutual distrust between doctors and patients and the overall low quality of medical services have not been effectively improved.Under the guidance of the goal of building a "healthy China" in an all-round way,how to improve the doctor-patient trust relationship and improve the quality and supply of medical services has become an urgent issue that restricts the in-depth reform of China's public hospitals and even social harmony and stability.Starting from the root causes of mutual distrust between doctors and patients and the low quality of medical services in China,this paper conducts research on the interaction mechanism between doctor-patient trust and the quality of medical services.The specific research contents include: Factors affecting doctor-patient trust,factors affecting medical service quality,interaction mechanism between doctor-patient trust and medical service quality,and strategies to further improve doctor-patient relationship and improve medical service quality.Based on the above problems,the research of this paper is carried out through the following processes:(1)collect and sort out relevant literature,sort out relevant theories,define the core concepts to define the research boundary,preliminarily put forward the theoretical model,put forward the research hypothesis and develop the questionnaire accordingly;(2)Conducting empirical investigation,using the doctor-patient trust scale and SERVQUAL scale to measure the doctor-patient trust and medical service quality respectively,and collecting the demographic and sociological characteristics of the research subjects;(3)Verify the medical service quality model of doctor-patient trust according to the survey results.On the basis of in-depth analysis of data characteristics,a variety of methods were used to construct the model,and the results of different models were compared to explore the key influencing factors of doctor-patient trust and medical service quality;(4)Comprehensive use of canonical correlation analysis,path analysis and other analysis methods to analyze the key variables and pathways of the interaction between doctor-patient trust and medical service quality;(5)Analysing the key variables of the model to explore strategies for improving doctor-patient trust and medical service quality.Finally,the conclusions of this paper are as follows:(1)A total of 1,936 patients from four hospitals were surveyed,with good sample representation.75.6% of patients trusted hospitals and 78.2% of patients trusted doctors(total score ?3).It shows that patients' trust in hospitals and doctors is not bad,but there is a large room for improvement.(2)Patients' demographic and sociological characteristics and social mentality have influence to the hospital trust,of which the patient's doctor category(hospitalized patients in the outpatient service),life satisfaction(more satisfied with more trust),attitude to life(more positive with more trusting),degree of education(degree is lower,the more trust)impact on hospitals and doctors trust are larger.Patients' demographic and sociological characteristics and social mentality have an impact on the evaluation of medical service quality.Including the patient's doctor category(higher in hospitalized patients),life satisfaction(the more satisfied the better),attitude toward life(the positive comments on the better),degree of education(the lower the higher education evaluation),the source of the patient(the locals better than outsiders),part of the year of birth and individual income have bigger influence on the medical service quality evaluation.(3)Trust in hospitals,doctor-patient trust and medical service quality are highly correlated.The results of canonical correlation analysis showed that the first canonical variable V1 of doctor-patient trust mainly reflected the items C10,C5 and C8 in the doctor-patient trust scale,while the first canonical variable W1 of medical quality mainly reflected the items D21,D22,D6,D14,D18,D16,D17 and D7 in the medical service quality scale.It indicates that the above items are the most important items in the scale,and the improvement of the above items can jointly improve the doctor-patient trust and the quality of medical services.(4)The results of path analysis showed that the path analysis model based on doctor trust as a mediating variable was better,and in the path analysis,doctor-patient trust was mainly affected by patients' type of medical treatment,life satisfaction,gender,whether they had visited a doctor,perceived family economic level,whether they were unemployed,and whether they were born in 1960-1970;The quality of medical service is mainly affected by the type of patients,the attitude towards life and the source of patients.Trust in hospitals is mainly affected by the type of treatment,life satisfaction,life attitude,education level and emphasis on health of patients.(5)Structural equation model shows that the transmission mechanism of medical service quality is: patient characteristics ? medical service quality;Patient characteristics ? hospital trust ? medical service quality;Patient characteristics? trust to doctors ? medical service quality;Trust in hospitals ? trust in doctors? quality of medical services.The transmission mechanism of trust in doctors is as follows: patient characteristics ? trust in doctors;Patient characteristics ?medical service quality ? trust to doctors;Patient characteristics ? trust in the hospital ? trust in the doctor.The transmission mechanism of trust in hospitals is as follows: patient characteristics ? trust in hospitals;Patient characteristics ?medical service quality ? trust to hospital;Patient characteristics ? trust in doctors ? trust in hospitals.The research suggests that we should improve the doctor-patient trust and medical service quality from the following aspects:(1)establish the brand effect of public hospitals to enhance the doctor-patient trust;(2)strengthen doctor-patient communication to improve trust so as to improve the quality of medical services;(3)improve the quality management of medical services in hospitals to enhance the trust between doctors and patients;(4)The government,society and individuals form joint efforts to improve doctor-patient trust.The innovation of this paper lies in:(1)it takes trust theory and medical service quality evaluation as its unique starting point,and its theoretical perspective is relatively new;(2)A variety of models are used to construct the interaction between doctor-patient trust and medical service quality.The models are mutually verified and complementary,which further strengthens the scientific nature of empirical research;(3)It is demonstrated that patients' trust in hospitals is an important mediating variable in the transmission mechanism of the interaction between doctor-patient trust and medical service quality,so as to expand the research field of doctor-patient trust and medical service quality.