Violence against healthcare workers and other serious responses to medical disputes in China: Surveys of patients at 12 public hospitals

Yuxian Du, Wenxin Wang, David J. Washburn, Shinduk Lee, Samuel D. Towne, Hao Zhang, Jay E. Maddock

Research output: Contribution to journalArticlepeer-review

31 Scopus citations


Background: Workplace violence against healthcare workers is a global issue that is on the rise, with Chinese healthcare workers facing growing challenges with hospital violence. Attacks on medical staff have increased in recent years with no clear resolution. Prior research focused on policies to improve the doctor-patient relationship and better protect clinicians, but few studies addressed the patient perspective. This paper examines patients' choices when facing a medical dispute and identifies groups who are more likely to respond to conflict with violence or other serious actions. Methods: Patient survey responses were collected in 12 leading public hospitals in five Chinese provinces with 5556 participants. The survey asked sociodemographic information, patients' attitudes (e.g., general optimism, trust in their physicians, perceived healthcare quality), and their primary response to a medical dispute. From least to most severe, the options range from "complaining within the family" to "violence." We used t-tests and Chi-square tests to explore the relationships between reactions and patient characteristics. We also performed multivariable logistic regressions to determine the impact of sociodemographics and provider trust on the seriousness of responses. Results: The primary response of a third of respondents was complaining to hospital or health department officials (32.5%). Seeking legal help (26.3%) and direct negotiation with doctors (19.6%) were other frequent responses. More serious responses included 83 stating violence (1.5%), 9.7% expressing a desire to expose the issue to the news media, and 7.4% resorting to seeking third-party assistance. Patients who were more likely to report "violence" were male (OR = 1.81, p <.05), high-income earners (OR = 3.71, p <.05), or reported lower life satisfaction (OR = 1.40, p <.05). Higher trust scores were associated with a lower likelihood of a serious response, including violence (OR = 0.80, p <.01). Conclusion: Most respondents reported mild reactions when facing a medical dispute. Among those who reported the intent of serious reactions, some sociodemographic characteristics and the trust of physicians could be predictive. To prevent future hospital violence, this work helps identify the characteristics of patients who are more likely to seek severe approaches to medical dispute resolution, including resorting to violence. From these results, hospitals will be better able to target specific groups for interventions that build patient-provider trust and improve general patient satisfaction.

Original languageEnglish (US)
Article number253
JournalBMC Health Services Research
Issue number1
StatePublished - Mar 26 2020


  • China
  • Healthcare reform
  • Medical dispute
  • Physician-patient relationship
  • Violence
  • Yi Nao

ASJC Scopus subject areas

  • Health Policy


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