RESUMO
Objective To understand the current situation of doctors and nurses perceptions on doctor-patient relationship and its main influencing factors, and to make recommendations for further healthcare improvement. Methods Based on the survey results of the third-party evaluation of the National Healthcare Improvement Initiative of 136 public tertiary hospitals, we analyzed the doctors' and nurses' perceptions on doctor-patient relationship and the influencing factors. SAS 9.4 software was used to conduct variance test of doctors' and nurses' basic information and multivariate logistic regression analysis of the influencing factors of doctors' and nurses' perceptions on doctor-patient relationship. Results The recognition of doctors and nurses on the statement of "doctor-patient relationship has been getting better", their career identity and hoping children to study medicine varied significantly (P <0.05) with hospital type,age, department, academic rank, and annual income. The main influencing factors were patients' satisfactions and medical liability insurance (OR>1, P<0.05). Another main positive influencing factor was the communication duration between the doctor and outpatient(OR>1,P<0.05). Conclusions It is imperative to protect rights of doctors and nurses by enforcing relevant laws and regulations, and improving existing medical dispute handling mechanism. Other measures to this end include higher pay for medical workers equivalent to their value and career identity;media guidance by the government,which will all help create a better medical environment and doctor-patient relationship.
RESUMO
The 2nd round of the third-party evaluation of the National Healthcare Improvement Initiative was made during Dec 2016 and Jan 2017.The methods, organization and implementation of the survey and the technical roadmap were the same as those of the 1st round of evaluation.The total number of respondents was 94 218,including 19 773 doctors,24 315 nurses,29 105 outpatients and 21 025 inpatients. 142 typical cases were collected from sample hospitals.The key findings showed that, the National Healthcare Improvement Initiative has been implemented quite well in the 2nd year, achievements and challenges exist side by side.The overall satisfaction rate of both outpatients and inpatients was good, both were about 90%.Further improvement is expected.Hospital staff have been actively involved in this Initiative,but they are not satisfied with their working environments and compensations.
RESUMO
OBJECTIVE:To propose policy recommendations for China to solve medicines shortage fundamentally. METH-ODS:The causes of medicines shortage in China were analyzed. Chinese,American,Canadian and European literatures and the government website of typical countries about responses to medicines shortage since 2010 were searched and reviewed. RESULTS& CONCLUSIONS:Medicines shortage in China are due to regulation and policy changes and unfair competition. Both China and foreign countries face the problem of medicines shortage to some extent,either due to demand side or supply side. It is necessary to improve related laws and regulations to deal with medicines shortage,establish multi coordinative mechanism,shortage monitor-ing system and information and communication network platform with the patient-centered approach,leave reasonable profit for pharmaceutical production and distribution enterprises and crack down hoarding of raw materials. The experiences of typical coun-tries in defining clear responsibility for each stakeholder in the medicines supply chain,establishing comprehensive policies and co-ordinative mechanisms in response to medicines shortage are valuable for China to follow.