医生信任的城乡差异及其形成机制——基于公平感视角的实证分析  

The Urban-Rural Difference of Doctors’Trust and Its Mechanism:Empirical Analysis Based on the Perspective of the Sense of Fair

作　　者：何晓斌 柳建坤 张云亮 HE Xiaobin;LIU Jiankun;ZHANG Yunliang(School of Social Sciences,Tsinghua University,Beijing 100084,China;Research Institute of Social Development,Southwestern University of Finance and Economics,Chengdu 611130,China)

机构地区：[1]清华大学社会科学学院,北京100084 [2]西南财经大学社会发展研究院,四川成都611130

出　　处：《西安交通大学学报（社会科学版）》2020年第6期109-118,共10页Journal of Xi'an Jiaotong University：Social Sciences

基　　金：四川省社会科学基金项目(SC20C038)。

摘　　要：在医患关系“日益恶化”的背景下,本文基于“中国社会状况综合调查”2013年的数据,将研究对象拓展到包含患者和非患者的公众整体,将宏观和微观两个层次的解释路径进行整合,同时关注社会结构因素和个体特征因素,考察了当前中国公众的医生信任和公共医疗分配感的城乡差异现象以及二者之间的关系。研究发现:(1)公众对医生的信任和公共医疗公平感均存在明显的城乡差异,具体表现为城镇居民对医生的信任程度更低,且更倾向于认为公共医疗资源分配是不公平的;(2)公共医疗公平感对城镇居民和农村居民信任医生都有促进作用,但这种影响在城镇居民中更大;(3)对于城镇居民而言,拥有就医经历可以削弱公共医疗公平感与医生信任的联系,但就医经历的负向调节作用在农村居民中并未体现。为此,相关部门应关注城乡差异,进行精准施策,增强公共医疗公平感,加强公众与医生的互动,从而增强公众对医生的信任,进而改善公众与医生的关系状态。In the context of the deteriorating relationship between doctors and patients,this paper examines the current urban-rural differences on the public’s doctor trust and public medical distribution sense and the relationship between them.Based on the survey data of Chinese Social Survey in 2013,this research expands the research object to include patients and non-patients,interprets the path at both macro and micro levels and draws attention to social structural factors and individual characteristics factors.The results show that:(1)the public trust in doctors and the sense of fairness on public health care are significantly different between urban and rural areas,and the doctors trust of urban residents is lower,even tend to think that the allocation of public medical resources is unfair;(2)the sense of public medical fairness can both promote the urban and rural residents’doctors trust,but this effect is more bigger in urban residents;(3)for urban residents,medical experience can weaken the relationship between public medical fairness and doctor trust,but the negative moderating effect is not reflected in rural residents.The policy implications of this study are:the relevant departments should pay attention to the differences between the urban and rural to implement precise policies,enhance the sense of fair in public health care,and strengthen the interaction so as to improve the relationship and the trust between the public and doctors.

关 键 词：医患关系 医生信任 城乡差异 公平感 公共医疗 资源分配 就医经历 

分 类 号：R197.1[医药卫生—卫生事业管理]