北京市三级医院医患信任机制问题研究:以社会学信任理论为基础

摘要

Objectives:To study on the status quo,types and establishment mechanism of Doctor-patient trust in tertiary hospital based on the theory of sociological trust.And to explore the improvement measures.Methods:On the basis of literature review,3 top tertiary hospital in Beijing were selected according to the medical resources allocation and hospital care to receive a 15 days field observation.The patients,doctors and managers were the observation objects.Results:The doctor-patient trust status quo in three hospitals is good.The trust type is mainly the general trust,and the reputation trust mode is the first operation mechanism,the relationship operation mode and the legal system trust mechanism coexist.The primary mechanism for the establishment of doctor-patient trust in tertiary hospital is reputation trust mode;the reputation trust mode is an important supplement to tight medical resources and legal trust mode is relatively weak.Conclusions:The reputation trust mode should be further promoted in the promotion of hierarchical healthcare system and legal trust should be further strengthened in the adaptability of the legal system and the hospital.%目的:以社会学信任理论为基础,研究北京市三级医院医患信任现状、类型与机制,进而探讨改善对策.方法:在文献研究的基础上,基于北京市医疗资源分布状况以及临床类别,选取3所三级甲等医院,对患者、医生和管理者进行为期15天的实地观察研究.结果:3所医院医患信任现状较好;信任类型以普遍主义信任为主,声誉型信任为第一运行机制,关系运作型和法制型信任机制并存.声誉型信任是北京市大型医院医患信任建立的首要机制;关系运作型信任是医疗资源紧张的重要补充;法制型信任机制较为薄弱.结论:声誉型信任应在推进分级诊疗制度中得到进一步提升;法制型信任应在法制与医院的适应中得到进一步强化.