患者普遍信任的结构与培育途径

A Study on the Structure of Patients General Trust and It's Training Way

患者信任分为对接诊医生的特殊信任和对医疗体系的普遍信任。理论和实证研究都表明,患者对医疗体系的普遍信任分为"对医务人员职业群体的信任"和"对医疗卫生制度的信任"两个维度。本文研制的患者普遍信任量表有较好的信度和效度,可以在今后的进一步研究中使用。此外,本文还研究了增进患者普遍信任的途径,并在数据分析的基础上,提出了相应的策略与建议。

The doctor-patient relationship is not ordinary consumption relationship,but a kind of principal-agent relationship that＇s based on trust,and the trust is the basis for the doctor-patient relationship.Other studies have shown that：patients＇ trust is divided into the special trust on some doctors as well as the generalized trust on the medical system.The paper emphasizes the dimensional structure of patients＇ generalized trust and the route of increasing patients＇ generalized trust.Both the theory and practical research in this paper have shown that：patients＇ generalized trust on the medical system is divided into two dimensions of ＂the trust on the occupational groups of medical personnel＂ and ＂the trust on the health care system＂.The scale of patients＇ generalized trust that＇s researched in the paper has good reliability and validity,which can be used in the follow-up further research.Based on the above mentioned research achievements,the paper holds that we need to pay attention to two aspects that the occupational image of medical personnel shall be remolded and the health care system shall be perfected in order to increase patients＇ generalized trust.For current medical environment,taking patients as the center and enhancing patients＇ satisfaction is the foundation to enhance the occupational image of medical personnel.Taking patients as the center,the meaning of survival and life quality shall be concerned,not only to cure the physical diseases,but also to assist patients for establishing good mental state and good social adaptability.Hospitals shall analyze and satisfy patients＇ recovery,emotion and social demands so as to comprehensive enhance the perceptive value of patients and improve patients satisfaction according to the requirement characteristics of patients＇ satisfaction.Besides,the medical personnel shall sufficiently respect patients＇ selection rights on the medical service and the informed consent right due to the information asymmetry.The following three aspects shall be strengthened for the improvement of medical treatment and public health：firstly,guarantee the cost reimbursement for public hospitals through the classified management of hospitals so as to fundamentally eradicate the profit motive of public hospitals.Secondly,strengthen the supervision and guidance on the clinical diagnosis and treatment.Thirdly,make policies,guide and encourage the innovation and application that＇s suitable for technologies.Specific suggestions of the following four aspects have been presented combined with the survey data of this time on the basis that the effective route theoretical research on the patients＇ generalized trust is enhanced：firsdy,perfect the external monitoring system of medical service.Establish professional supervision organizations of medical treatment and public service that are independent from the government,meanwhile exert the supervision of self-regulatory organizations in medical treatment and public health industries and consumer rights protection organizations on the service of medical treatment and public health so as to form the multilevel medical treatment and public health supervision system.Secondly,establish reasonable system of medical charges.Reasonably improve the labor service price of medical treatment technology on the basis that the ratio of drug income in the total income of medical treatment is reduced so as to make doctors obtain corresponding compensation and remuneration through the income of medical technical service.Thirdly,establish scientific drug supply and guarantee system.Establish clinical comprehensive assessment system of essential drugs,perfect the selection and adjustment system of national essential medicine list and standardize the purchasing mechanism of essential drugs.Fourthly,strengthen the protection on the patients＇ interests.Make special laws of protecting the patients＇ rights,standardize patients＇ rights and obligations and establish diversified rights relief mediods so as to practically implement patients＇ rights.