医疗信息来源渠道如何影响患者信任——基于网络媒介与就医经历的对比分析  

How Does the Source of Medical Information Affect Patient Trust:A Comparative Analysis Based on Online Media and Medical Experience

作　　者：李子豪 顾海[1] 顾淑燕 LI Zihao;GU Hai;GU Shuyan(School of Government,Nanjing University)

机构地区：[1]南京大学政府管理学院

出　　处：《公共管理评论》2023年第4期128-152,共25页China Public Administration Review

基　　金：江苏省社会科学基金基地项目“江苏重大突发公共卫生事件多主体协同应急响应机制研究”(项目批准号:20JD001)资助

摘　　要：医患信任是构建和谐医患关系的核心议题。本文基于中国社会状况综合调查(CSS2017)数据,从医疗信息来源的不同渠道出发,分别探讨网络信息获取与线下就医经历对患者信任的影响、具体影响机制及影响效果差异性。研究发现:第一,中国患者信任内部的医生信任与医院信任具有互补性;第二,公众通过网络媒介获取医疗信息会降低患者信任,医疗风险感知在这一机制中发挥了正向中介效应;第三,公众线下就医经历对患者信任具有提升效应,机制分析表明制度感知存在部分中介效应;第四,公众网络医疗信息获取对患者信任的影响程度强于线下就医经历,相比医务工作者,公众更愿相信来自互联网中的医疗信息,这也表明患者信任具有不对称性。因此,提升患者信任要从政府提供医疗服务出发去提升医方与患方的接触效应,从互联网媒体角度出发去规范媒体树立和宣传正确医疗观念的行为,从多主体协同治理角度出发去构建医患共同体,以此提升患者信任,实现医患关系的有效治理。Doctor-patient trust is a core issue in building a harmonious doctor-patient relationship.Trust of patients in doctors not only includes personalized special trust but also general trust.The public obtains medical information directly through offline medical experiences,which enhance doctor-patient familiarity and establish interpersonal doctor-patient trust.The process of establishing universal trust is influenced more by indirect medical information obtained through online communication channels.When the public obtains medical information directly through offline medical experience,professional workers often use rational persuasion that is difficult for the public to understand,thus making it difficult to have a substantial impact.With the continuous promotion and application of the Internet,the dissemination of information on the Internet will have an increasing impact on the mentality and even the behavior of the public.This raises the research question in this article.From the perspective of the various channels to acquire medical information,can public acquisition of online medical information and medical experience have an impact on patient trust?Specifically,through what mechanisms do online medical information and medical experience affect patient trust?Is there a difference in the impact of the two medical information acquisition channels on patient trust?Previous research does not provide any answers.In order to answer the above questions,this article is based on data from the Comprehensive Survey of Social Conditions in China(CSS2017).First,it analyzes the patient trust structure and constructs the patient trust variables through doctor trust and hospital trust.Starting from various sources of medical information,it explores the impact of the acquisition of online information and offline medical experience on patient trust,the specific impact mechanisms,and the different impact effects.Research finds that,first,there is a complementarity between the trust of Chinese patients and the mutual influence o

关 键 词：医疗信息 网络媒介 就医经历 患者信任 医疗风险感知 制度感知 

分 类 号：R197.3[医药卫生—卫生事业管理]