Defensive medicine and its contributing factors of public hospitals in China:Research findings from a physician survey in a city of Guangdong province
10.3969/j.issn.1674-2982.2014.10.007
- VernacularTitle:公立医院医生防御性医疗行为及其影响因素研究--基于广东省某市公立医院医生问卷调查的实证研究
- Author:
Jingwei HE
- Publication Type:Journal Article
- Keywords:
Defensive medicine;
Doctor-patient relationship;
Cost containment;
Overprovision of care;
Health policy
- From:
Chinese Journal of Health Policy
2014;(10):33-39
- CountryChina
- Language:Chinese
-
Abstract:
The rapid cost escalation and vast supplier-induced demands in the Chinese health care system are well-known to the health policy research community. The existing literature tends to explain the pervasive overprovision of care by financial incentives of hospitals and physicians. Behind this is a series of misaligned perverse incentives embedded in the Chinese health system for decades. With a survey of public hospital physicians in a city of Guangdong, this study re-veals that the overprovision of care, especially overprescription, is not solely driven by economic incentives, but also by physicians’ motive of avoiding potential disputes with patients, reflecting defensive medical behaviors. The survey was con-ducted in December 2013, which selected 504 licensed physicians by random sampling. The regression analysis suggests that low income and the perceived imbalance between efforts and rewards indeed contribute to physicians’ motivation of de-fensive medicine. In the meantime, their past experiences of medical disputes with patients are also found significantly as-sociated with defensive behaviors. This study has revealed the critical impacts of the escalating tension between doctors and patients in distorting physician’ behaviors, and lays out policy recommendations.
