医院公信力对患者抱怨行为层次的影响

The effect of public trust in hospital on complaint behavior level

本研究旨在探讨医院公信力对医疗服务抱怨行为层次的影响,以期为医疗公信力的践行提供理论依据。331名有过不满意就诊或住院医疗服务抱怨经历的患者参与了线上问卷调查。结果显示:(1)医院公信力对一般抱怨水平和是否向第三方抱怨有正向影响;(2)医院公信力对一般抱怨水平和是否向第三方机构抱怨的影响机制不同,对一般抱怨水平高低的影响主要通过患者就诊的不满意度,而对是否向第三方抱怨则通过抱怨的预期收益影响;(3)医院公信力对是否向第三方抱怨的影响效果(0.301)要大于其对患者一般抱怨水平的影响效果(0.060);(4)医院公信力也会通过对医疗服务质量的期望落差、患者对医生的信任对一般抱怨水平与是否向第三方抱怨同时产生影响,但相比其直接通过患者就诊不满意度、抱怨的预期收益的影响要小,尤其是通过患者对医生的信任产生的间接影响很小。这表明医院公信力践行离不开微观层次的抱怨管理,一方面可能通过基于关系的医患沟通培训提升医生沟通技能及抱怨管理人事来改善患者对医疗服务的信任,另一方面更应该通过改善医疗服务报怨管理制度与机构设立来提升。

The present study aims to explore the effect of public trust in hospital on complaint behavior in healthcare service, which could provide the foundation for the practice of public trust in hospital. A total of 331 par- ticipants who had complained about having a poor consultation experience in hospital were asked to answer the online questionnaire. The results show that ： （ 1 ） public trust in hospital had a positive effect on both general complaint and third-party complaint, but its effect on third -party complaint was much higher; （2） public trust in hospital affected general complaint via consultation dissatisfaction, but it influenced third -party complaint via anticipated benefits of complaint ; （ 3 ） public trust in hospital also influenced both the two types of complaint behavior via expectation gap of heahhcare service and patients＇ trust in doctors, but their mediation effects, especially the one of patients trust in doc- tors which was much smaller than that of patient dissatisfaction and anticipated benefits of complaint. The results indi- cated that complaint management is important for the practice of public trust in hospitals. On one hand, complaint management personnel and communication skills could enhance public trust in health care. On the other hand, legal action about complaint management could guarantee public trust in health care providers.