Background Violence against doctors in China is a serious problem that has attracted attention from both domestic and international media. Objective This study investigates readers’ responses to media reports on violence against doctors to identify attitudes toward perpetrators and physicians and examine if such trends are influenced by national policies. Methods We searched 17 Chinese violence against doctors reports in international media sources from 2011 to 2020. We then tracked back the original reports and web crawled the 19,220 comments in China. To ascertain the possible turning point of public opinion, we searched violence against doctors–related policies from Tsinghua University ipolicy database from 2011 to 2020, and found 19 policies enacted by the Chinese central government aimed at alleviating the intense patient–physician relationship. We then conducted a series of interrupted time series analyses to examine the influence of these policies on public sentiment toward violence against doctors over time. Results The interrupted time series analysis (ITSA) showed that the change in public sentiment toward violence against doctors reports was temporally associated with government interventions. The declarations of 10 of the public policies were followed by increases in the proportion of online public opinion in support of doctors (average slope changes of 0.010, P<.05). A decline in the proportion of online public opinion that blamed doctors (average level change of –0.784, P<.05) followed the declaration of 3 policies. Conclusions The government’s administrative interventions effectively shaped public opinion but only temporarily. Continued public policy interventions are needed to sustain the reduction of hostility toward medical doctors.
BackgroundMultiple drug resistant (MDR) intra-abdominal infections (IAIs) are associated with notable direct and societal costs. As previous studies have not considered the impact of MDR on the total medical costs (TMCs) of IAIs, the present one examines this, as well as further estimates the additional costs at a national level.MethodsThis is a retrospective study. Firstly, we randomly selected a sample of 40% of all inpatients discharged between 2014 and 2015 from a teaching hospital, due to limits in budget and the large number of patients. Then, we manually selected 254 patients with IAIs according to the International Classification of Disease, 10th revision, using electronic medical records. Eventually, 101 patients with IAIs (64 MDR patients and 37 non-MDR patients) were included after excluding cases without laboratory test results, any pathogens detected, or antimicrobial resistant pathogens. Univariate analysis and a generalized linear model were applied to assess the parameters associated with TMCs.ResultsCompared to non-MDR patients, those with MDR pathogens were significantly associated with higher TMCs, higher antimicrobial costs, higher antimicrobial usage, larger number of pathogens, and longer length of stay and were more likely to have insurance and combination antimicrobial therapy. In addition, the average TMC among patients with MDR pathogens was ¥ 131801, which is ¥ 90201 higher than those without MDR pathogens. If our results are applied to the whole country, the sum of all attributable TMCs was ¥ 37 billion. The societal costs, furthermore, were ¥111 billion in 2015.ConclusionOur results provide information that should lead to increased efforts to reduce inappropriate antimicrobial therapy, in order to decrease the emergence of MDR pathogens and to reduce their economic burden.
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