The impact of contract service policy and doctor communication skills on rural patient-doctor trust relationship in the village clinics of three counties

BMC Health Serv Res. 2019 Mar 22;19(1):187. doi: 10.1186/s12913-019-3875-x.

Abstract

Background: Trust is regarded as the cornerstone of the doctor-patient relationship in the world of medicine; it determines the decisions patients make when choosing doctors and influences patients' compliance with recommended treatments. In China, patient-doctor trust acts as a thermometer measuring harmony in the doctor-patient relationship. The objective of this study is to explore the relationship between the contract service and patient-doctor trust-building in 25 village clinics of rural China.

Method: The research was carried out in village clinics in rural China. A simple random sampling method was used to choose clinics and subjects. Based on feasibility and financial support, we chose three counties as our study settings: Dafeng District, Jiangsu Province; Yinan County, Shandong Province; and Wufeng Tujia Autonomous County, Hubei Province. Twenty-five village clinics and 574 subjects were selected in the three areas from the contract service and patient list. Descriptive statistics, t-tests, MANOVA, SEM, and multiple regression statistical analysis were employed to analyze the data.

Result: Statistical analysis showed that contract service directly and indirectly influenced patient-doctor trust-building in village clinics. The patient perception of doctor communication skills was a mediator in the relationship between contract service policy and patient-doctor trust-building.

Conclusions: Building patient-doctor trust is important in developing and enhancing rural health. The policy of contract service plays a significant role in building relationships. Well-developed communication skills of doctors contribute to the implementation of the contract service policy and to establishing patient-doctor trust.

Keywords: China; Communication; Contract service; Trust; Village doctors.

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • China
  • Communication*
  • Contract Services*
  • Female
  • General Practitioners*
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Physician-Patient Relations*
  • Rural Health
  • Rural Health Services*
  • Socioeconomic Factors
  • Trust