Abstract
BackgroundTrust is regarded as the cornerstone of the doctor-patient relationship in the world of medicine; it determines the decisions patients make when choosing doctors and influences patients’ compliance with recommended treatments. In China, patient-doctor trust acts as a thermometer measuring harmony in the doctor-patient relationship. The objective of this study is to explore the relationship between the contract service and patient-doctor trust-building in 25 village clinics of rural China.MethodThe research was carried out in village clinics in rural China. A simple random sampling method was used to choose clinics and subjects. Based on feasibility and financial support, we chose three counties as our study settings: Dafeng District, Jiangsu Province; Yinan County, Shandong Province; and Wufeng Tujia Autonomous County, Hubei Province. Twenty-five village clinics and 574 subjects were selected in the three areas from the contract service and patient list. Descriptive statistics, t-tests, MANOVA, SEM, and multiple regression statistical analysis were employed to analyze the data.ResultStatistical analysis showed that contract service directly and indirectly influenced patient-doctor trust-building in village clinics. The patient perception of doctor communication skills was a mediator in the relationship between contract service policy and patient-doctor trust-building.ConclusionsBuilding patient-doctor trust is important in developing and enhancing rural health. The policy of contract service plays a significant role in building relationships. Well-developed communication skills of doctors contribute to the implementation of the contract service policy and to establishing patient-doctor trust.
Highlights
Trust is regarded as the cornerstone of the doctor-patient relationship in the world of medicine; it determines the decisions patients make when choosing doctors and influences patients’ compliance with recommended treatments
Well-developed communication skills of doctors contribute to the implementation of the contract service policy and to establishing patient-doctor trust
Based on the above literature review and analysis, the main objective of this study was to explore whether there is a direct association between contract service and patient trust in doctors, whether doctors’ communication skills acted as a mediator, and whether both a direct and indirect association exist between contract service and patient trust in doctors in the village clinics of rural China, after controlling for sociodemographic factors, medical expenditures, and other health policy characteristics
Summary
Trust is regarded as the cornerstone of the doctor-patient relationship in the world of medicine; it determines the decisions patients make when choosing doctors and influences patients’ compliance with recommended treatments. The policy in rural China may be regarded as a Chinese counterpart of family medicine in western countries [9,10,11,12] It can be defined as a system of contracts signed between village doctors and villagers in household units that prompts village doctors to provide demand-tailored public health services like general practitioners [13]. The initial purpose of enacting the policy is to increase village doctors’ annual income and provide positive incentives; after the policy had been deeply implemented, health researchers and managers found that the doctor-patient relationship in rural areas had changed.
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