Abstract
Background and Objective: China has launched a series of reforms to enhance primary care. The aims of these reforms are to strengthen the functionality of primary care to encourage patients to use primary care. Patients’ trust in physicians is important in clinical medicine; however, little is known about how Chinese patients’ preferences relate to their trust in primary care physicians. This study’s objectives are to measure the Chinese public’s trust in primary care physicians and to characterize reasons of their preferences for health care. Materials and Methods: This quantitative study comprises a face-to-face survey with a convenience sample (n = 273) of people visiting community health centers or stations (CHCSs) in Wuhan, China. We measured the patients’ preferences for the different level of hospitals and their trust in physicians, as well as the reasons of the patients’ preferences, using a Chinese version of the Wake Forest Physician Trust Scale and other variables (such as demographics, health status, and hospital preference). Results: Approximately two thirds (68.6%) of the participants had experienced a mild or chronic disease in the year before the survey, but only 26.4% preferred to visit CHCSs in such cases. The negative factors related to this lack of preference are the physicians’ competence (odds ratio [OR] = 0.250), the medical equipment (OR = 0.301), and the popularity of hospitals (OR = 0.172). The positive factors were ease of access (OR = 2.218) and affordability (OR = 1.900). The participants expressed a moderate trust in physicians in CHCSs (score of 3.02 out of 5). There is no association between the patients’ trust and their hospital preference (r = 0.019, p = 0.859). Of the participants, 92 suggested that the physicians in CHCSs should improve in terms of their competence (n = 53), attitude (n = 35), and/or medical ethics (n = 16). Conclusions: This study’s results suggest that patients consider improving physicians’ competence to be more important and urgent than improving those physicians’ trustworthiness in terms of reconstructing Chinese primary care. Improving the physicians’ competence would not only reduce the barriers that patients experience regarding CHCSs, but would also increase their trust in the physicians.
Highlights
Primary care is the foundation of the health care delivery system to ensure equal access and reduced costs
The primary care includes Chinese community health centers or stations (CHCSs), which are located in urban areas, and township health care centers, which are located in rural areas
The C-Wake Forest Physician Trust Scale (WFPTS) has been tested in some tertiary hospitals in China (Cronbach’s α = 0.83), the new translations that we used in this study have not been tested in CHCSs
Summary
Primary care is the foundation of the health care delivery system to ensure equal access and reduced costs. The Chinese government launched a series of reforms to rebuild its underdeveloped primary care system during the market economic reform period [1,2]. Before the health care reform, most of the Chinese public could freely choose an affordable hospital to visit when they got sick [5]. Health care became more expensive and more difficult to access when patients began frequenting high-level hospitals. China has launched a series of reforms to enhance primary care. Patients’ trust in physicians is important in clinical medicine; little is known about how Chinese patients’ preferences relate to their trust in primary care physicians. This study’s objectives are to measure the Chinese public’s trust in primary care physicians and to characterize reasons of their preferences for health care. We measured the patients’ preferences for the different level of hospitals and their trust in physicians, as well as the reasons of the patients’
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