Skilled doctors in tertiary hospitals are already overworked in China

Hu, Yinhuan; Zhang, Zixia

doi:10.1016/s2214-109x(15)00192-8

Cited by 63 publications

(64 citation statements)

References 3 publications

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“…The socio-demographic characteristics show that the majority of health care professionals had a low-level medical education, which is in line with other studies [12,30,31]. However, the professional knowledge improved significantly in the intervention group, indicating that the professional skills training sessions positively affected the participating health care professionals.…”

Section: Discussionsupporting

confidence: 89%

Shifting the Care of Type 2 Diabetes Mellitus from Hospital to Primary Health Care Institutions through an Educational Intervention for Health Care Professionals: An Example from Rural China

Chen

Qian

Burström

2020

IJERPH

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This study assessed the impact of an educational intervention on the knowledge, attitudes, and practice regarding Type 2 Diabetes Mellitus (T2DM) of Primary Health Care (PHC) professionals, as well as on the types of T2DM care services which they were able to provide. The intervention was carried out in collaboration with county hospitals. The study was conducted from 2015 to 2016 among 241 health care professionals in 18 township health centers and 55 village clinics in three counties in Jiangsu Province, randomly divided into an intervention group and a control group. Participants in the intervention group received professional skills training sessions and team communication and were involved in regular meetings. The control group followed the routine work plan. At one-year follow up, the diabetes knowledge score, practice score, and attitudes score were significantly higher in the intervention group than in the control group. A significantly higher proportion of health care professionals in the intervention group was able to provide services compared with the control group, for all types of services, except T2DM emergency treatment. The intervention among health care professionals in PHC had a positive impact on their professional diabetes skills, knowledge, attitudes, practices, and types of services they were able to provide, at one-year follow-up.

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Section: Discussionsupporting

confidence: 89%

Shifting the Care of Type 2 Diabetes Mellitus from Hospital to Primary Health Care Institutions through an Educational Intervention for Health Care Professionals: An Example from Rural China

Chen

Qian

Burström

2020

IJERPH

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“…They are therefore unlikely to complain or perceive problems with PPR, even when working hard. Second, patients in China have a completely free choice of hospital [ 47 , 48 ], and most favor general hospitals providing higher levels of care, regardless of the higher fees or the levels of crowding [ 49 ]. Providers may see having lots of patients as a measure of patients’ approval, and even an honor.…”

Section: Discussionmentioning

confidence: 99%

Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China

et al. 2017

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ObjectivesTo provide an empirical examination of patient–provider relationships (PPR) and its association with organizational and individual factors.MethodsA national cross-sectional survey was conducted by stratified cluster sampling in 77 hospitals across seven provinces in China between July 2014 and April 2015, involving 3621 doctors, 5561 nurses, and 8022 patients with response rates of 62.93%, 61.16%, and 33.08%, respectively. Self-perceived PPR was the outcome variable. Organizational factors included hospital type (western medicine [WM] and traditional Chinese medicine [TCM] hospital); hospital level (tertiary and secondary hospital); area of specialization (internal medicine and surgery); ratio of doctors (nurses) to ward beds; doctors/nurses’ concerns about performance assessment; and patients’ perceptions of healthcare cost. Individual factors included consultation, listening to patients and socio-demographic factors.Results54.6% of doctors, 36.6% of nurses, and 10.2% of patients perceived PPR as poor. Organizational factors independently associated with providers’ perception of poor PPR included hospital type (WM vs TCM: OR = 1.25 [95% CI: 1.06–1.47]) and concerns about performance assessment (high vs low levels: OR = 1.40 [95% CI: 1.14–1.72]) for doctors, and concerns about performance assessment (average vs low levels: OR = 0.79 [95% CI: 0.67–0.93]) for nurses. Those associated with patients’ perception of poor PPR included hospital type (WM vs TCM: OR = 0.63 [95% CI: 0.53–0.74]) and hospital level (tertiary vs secondary: OR = 0.65 [95% CI: 0.51–0.82]). Doctors and nurses reporting listening to patients “frequently” had better perceptions of PPR (OR = 0.46 [95%CI: 0.38–0.56] and 0.49 [95% CI: 0.41–0.59] for doctors and nurses, respectively), as did their patients (OR = 0.24 [95% CI: 0.18–0.31] and 0.54 [95% CI: 0.35–0.84] for doctors and nurses, respectively).ConclusionsAlthough our findings require validation in different organizational settings given the likely variability of these associations across systems, our results suggest that implementing moderate levels promoting the level of medical treatment, and broadening doctors/nurses training regarding listening to patients, may benefit to enhance PPR.

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“…33 Patient preference increases the likelihood of medical errors in tertiary hospitals. Excessive visits limit the time allowed for clinical reception, 34 and the increasing workload of doctors often induces medical errors. The more advanced technology for diagnosis and treatment in tertiary hospitals plays a fundamental role in the therapeutic process, so patients often regard tertiary hospitals as a "lifesaver".…”

Section: There Are Differences Between Medical Institutions Of Dissimmentioning

confidence: 99%

<p>Relating Medical Errors to Medical Specialties: A Mixed Analysis Based on Litigation Documents and Qualitative Data</p>

Liu¹,

Liu²,

Gong³

et al. 2020

RMHP

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Background: We know a great deal about types, causes, and prevention of medical errors, as well as the risks of each medical specialties. Although we know something about medical errors, much remains to be done in this area particularly around effective prevention. However, little is known about whether medical errors are related to medical specialties. Our objective was to categorize and map the distribution of medical errors and analyze their relationships with medical specialties. Methods: First, public cases of medical disputes were searched on "China Judgment Online" according to the key words including medical errors. Second, we set up a database with 5237 medical litigations. After removing unrelated judgment documents, we used systematic random sampling to extract half of these. Then, we hired two frontline physicians with M.D. to review the litigation documents and independently determine the medical errors and the departments in which they took place. A third physician further reviewed the divergent results. After the descriptive statistical analysis and mind map analysis, semi-structured interviews were further conducted with 63 doctors to reveal the relationships mentioned above. Results: More than 97.8% of medical errors occurred in clinical departments. The insufficient implementation of informed consent obligations is the top medical error in all medical departments [internal medical departments (12.86%, N=36), surgical departments (14.57%, N=106), specialist departments (13.16%, N=86)]. The types of medical errors in diverse medical departments might be associated with therapeutic means used by physicians. Errors related to surgical operations were common in surgical departments, errors related to diagnoses were common in internal medicine departments, and errors related to therapy were common in specialist departments. A lack of clinical experience and undesirable work system design have contributed to the occurrence of medical errors. Inadequate human resources and unreasonable shift systems have increased the workload of staff members and this has in turn increased the incidence rate of medical errors. Conclusion: Medical departments are facing medical errors both in humanity and technology. Medical institutions should be alert to the harm caused by medical humanity (mainly including insufficient communication between physicians and patients, insufficient implementation of infringement of informed consent, infringement of patient's privacy and overtreatment). Improving the clinical skill and vigilance of medical staff is a top priority. Medical institutions should also improve undesirable system designs.

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Skilled doctors in tertiary hospitals are already overworked in China

Cited by 63 publications

References 3 publications

Shifting the Care of Type 2 Diabetes Mellitus from Hospital to Primary Health Care Institutions through an Educational Intervention for Health Care Professionals: An Example from Rural China

Shifting the Care of Type 2 Diabetes Mellitus from Hospital to Primary Health Care Institutions through an Educational Intervention for Health Care Professionals: An Example from Rural China

Impact of organizational and individual factors on patient-provider relationships: A national survey of doctors, nurses and patients in China

<p>Relating Medical Errors to Medical Specialties: A Mixed Analysis Based on Litigation Documents and Qualitative Data</p>

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