A certain positive correlation exists between medical complaints and medical business volume[22–24]. However, we find in our research that this correlation is insignificant (p=0.158). This result does not confirm that the medical business and medical complaints are irrelevant, but it only proves that this relationship can be controlled or even changed by taking practical measures. In our hospital, we have been paying attention to the relationship between medical complaints and business volume since 2016 by focusing on the collection of deficiencies and deficiencies exposed in medical complaints and combining the hospital’s actions to improve medical services, quality and safety enhancement years, and volunteer actions. We will systematically rectify medical defects, improve medical procedures, and optimize medical links. Especially since 2018, we regularly report and display medical complaints in the whole hospital and organize learning and discussions, which helps increase risk awareness of medical staff, improve service quality, enhance service attitudes, and keep harmonious doctor-patient relationship. The growth of the medical business volume can ensure the decline or low increase in medical complaints.
Among the 1,481 medical complaints we have obtained, more than half of the medical complaints are from petition complaints transferred by the administrative department (911, 61.5%). Although the hospital has established a relatively standardized and standard complaint acceptance procedure, patients usually do not have a very good understanding of the hospital’s process of receiving and accepting medical complaints and often choose the relatively easy government complaint hotline[5, 11]. This situation shows that the hospital’s existing complaint acceptance mechanism is not perfect, and the complaint channels are not smooth and convenient. Therefore, we should further strengthen complaint management, increase publicity, optimize the medical complaint acceptance and reception process, facilitate complaint channels, establish a monitoring and early warning mechanism, and improve the efficiency of complaint acceptance and response in the hospital[25].
After conducting hierarchical clustering of 111 specific indicators in 7 categories and 11 subcategories, we find that the personnel (doctors, nurses, technicians) and clinical departments (outpatient, emergency, pediatrics, obstetrics, and gynecology) are the major groups and departments of medical complaints. The process of treatment and the communication and attitude of medical staff are the main aspects of complaints, which are consistent with the results of other studies[5, 11, 21]. However, different from previous studies, as a newly built hospital, our focus and concern in complaints about personnel and departments is the lack of medical staff and the incomplete setting of departments. We also have a large number of complaints in terms of hospital facilities, equipment, and diet. This finding reminds our newly opened hospitals to improve the medical humanistic care and communication skills of medical staff and strengthen the communication between doctors and patients. At the same time, we should pay more attention to the provision of medical resources and the improvement of supporting facilities such as logistics support to provide patients with suitable and accessible medical services for creating a warm and comfortable medical environment to meet the needs of patients[26, 27].
Although correspondence and telephone calls are our main means to resolve medical complaints, of the 1372 complaints resolved by telephone and correspondence, only 68 cases and less than 5% (68/1372) are replied by formal correspondence, and the rest are all understanding through telephone communication and may be related to traditional Chinese concepts and modern social methods. We are not very good at using formal letters to respond to complaints. We also find through the analysis of the complaint data and resolution methods that the 22 invalid complaints that are excluded and 18%( 247/1372) of the 1372 complaints resolved by letter and telephone are simply complaints and venting their dissatisfaction. No specific demands are made in the actual complaint. They will complain as long as they encounter dissatisfaction in any part of the treatment, or if their expected needs are not met and special care is taken. Through communication via telephone, these people are satisfied with the hospital's explanation. Therefore, for this part of the complaint, only 20% of the time is needed to process the feedback. We should devote more energy to those medical complaints that really warn of defects and loopholes in hospital quality and safety, especially adverse events that can cause medical disputes and medical malpractice; we should also improve the response efficiency and ability of responding to such medical complaints[28, 29].
We find after collating and reviewing the data that, out of 99 medical complaints resolved through hospital consultation and third-party mediation, 47% are unsatisfied with the previous telephone response. This part of the patients thought that they are not satisfied with the telephone or in response to complaints in the form of letters; the hospital did not conduct adequate dialogues and investigations, did not provide suitable solutions, and did not pay sufficient attention and maintenance to its rights[30], which led to the escalation and deterioration of complaints. Therefore, any medical complaints should not be taken lightly at all times. Appropriate and proper ways and means should be adopted to deal with medical complaints to improve the patient's sense of experience and sense of acquisition[31, 32].
Research Limitation
Our research also has some shortcomings. First, we collect and organize medical complaint data manually, and we lack a standardized and scientific management information system[33], which may have artificial perception effects on classification, screening, and analysis[34]. Second, when accepting medical complaints, we only register the patient’s gender and do not record other sociodemographic factors, such as age, income, occupation, marital status, and education level; as a result, we could not analysis and discuss the correlation between demographic sociology and medical complaints[8]. Considering the lack of a unified standard for the classification of medical complaint, we have classified 111 specific indicators in 7 categories and 26 sub-categories. However, some complaints cannot be classified, which may miss some important medical complaint information, which is not conducive to the quality improvement and safety of the hospital. Finally, in actual work, the choice of complaint resolution is random and subjective and depends on the staff’s artificial judgment on the natural and severity of the complaint. In some cases, the hospital chooses to negotiate and resolve the complaint quickly without investigating its cause and background to solve the problem as soon as possible, eliminate the effect, and clam down the matter. This kind of behavior may cause the exclusion and shielding of important information. Thus, the strategies needed for the hospital's continuous improvement may be difficult to obtain.