Research On The Construction Of Physician Credit Evaluation Index System From The Perspective Of Patients

Objective:With the deepening of China's medical and health reform,the social credit construction in the field of health planning as an important part of China's social credit construction is particularly important.At present,in the field of credit risk and its influencing factors,the existing literature is limited to the field of Finance and economics,and there is no correlation between physician's credit risk and its influencing factors.This study from the two aspects of individual physicians and hospital management,through screening and constructing credit risk index system of physicians,social surveys,research in the credit status of the medical practitioners of the behavior and credit risk factors,in order to provide suggestions for alleviating the crisis of doctor-patient trust,create a harmonious doctor-patient relationship,to provide evidence for physician behavior and management for the hospital management.Methods:Literature retrieval system and tools are widely used to collect literatures and materials related to credit mechanism and credit risk research both at home and abroad.The status and progress of related research contents and research methods both at home and abroad are reviewed,and an evaluation index system is constructed.Expert consultation will be conducted at the stage of research and implementation.A total of 10 experts in the field of health management,hospital management,community health management and health administration were selected.Through two rounds of expert consultation,using AHP weighting,sorting expert opinion letter,form the item pool of credit risk influence factors of medical behavior.On the basis of expert consultation,combined with empirical research,we sampled the sample of medical institutions,collected physician's credit status,credit risk factors and other related information data,and analyzed the results and conclusions.Results:(1)Through two rounds of expert consultation and demonstration,the comparative analytic hierarchy process is used to empower,establishing and determining the evaluation index system and weight of practitioner' credit under the perspective of patients:1.Expert enthusiasm is better;2.The selected experts have high authority in the field of research and the consistency of expert evaluation is good;3.Through two rounds of expert demonstration,the index system is finally formed:4 first grade,11 in two level and 32 for three;The first index:diagnosis and treatment technology and ability of the maximum weight(0.424),followed by the professionalism and quality of medical ethics(0.320),and the professional norms and standards(0.146),the last is medical quality and service(0.109).(2)A questionnaire survey was conducted on two hospitals(three a)and two community health service centers as the research site.The patients in these medical institutions were selected as the research objects,149 valid questionnaires in the community:1.The general demographic characteristics are obvious;2.The conformity degree and satisfaction degree of diagnosis and treatment quality and technical ability were analyzed.The index A11 accords with the highest degree.The satisfaction of the overall medical service in the medical process is 88.18%,and the satisfaction of the personal professional reputation of the Chinese medical students in the process of diagnosis and treatment is 82.12%;3.The conformity degree and satisfaction degree of norms of practice and medical ethics were analyzed.The index C11 accords with the highest degree;4.Analysis of the risk factors of doctors,credit risk under the patient's perspective by logistic regression model.The risk factors are health insurance types(P=0.023<0.05,OR = 12.18),9h index(P=0.010<0.05,OR = 2.703)and 12k index(P=0.020<0.05,OR = 2.401),education is a protective factor(P=0.002<0.05,OR = 0.569),Conclusion:In view of the results of the study,the government level should improve the medical security system and improve the sense of medical availability.The two is to strengthen the management of doctors' qualification and to check the qualification of doctors.The level of medical institutions is to improve the credit rating of medical institutions and to expand their reputation and influence.The two is to strengthen the construction of medical ethics,enhance credibility,establish a management system of medical ethics medical archives.Three is to strengthen medical and communication skills training,cultivate professional awareness,and develop a personalized skills training system.Four is to establish the management mechanism of negative behavior of doctors,to supervise the behavior of dishonesty and to give full play to the social role of the third party.At the personal level,doctors should enhance their personal conduct and quality accomplishment,set up a good image,consolidate health laws and regulations,learn professional practices,and ensure medical quality and patient safety.