3.1 Characteristics of the sample
The background characteristics of the participants are shown in Table 1. Female make up the majority of participants (MP 63.64%, GP 61.40%). The largest number of Participants live in Provincial capital cities/Municipalities (MP 51.95%, GP 56.23%). The age of the participating GPs is relatively average, while the most MPs participating in the survey are 26-35 years old (53.90%). In terms of education, MPs has the most Master's degree (50.65%) and GPs has the most Undergraduate (38.30%). A total of 41 (26.62%) of the 154 MPs believed the DPR to be tense, 96 (62.34%) thought it to be average, and only 17 (11.04%) thought it to be harmonious. Of the 329 GP respondents, 88 (26.75%) believed that the current DPR was tense, 192 (58.36%) thought it was average, and 49 (14.89%) thought it was harmonious. The cognitive difference of the current situation for the DPR between medical personnel and non-medical personnel is shown in Figure 1. Among the MPs, age, gender, department, years on the job, professional title, hospital level, type of practice, education, and place of residence had no statistical significance on the evaluation of the DPR (p>0.05). Among the GPs, gender, work type, education, place of residence, and prior hospital admittance had no statistical significance on the evaluation of the DPR (p>0.05); the data are given in Table 2. Age, however, was a statistically significant factor in the GPs on the evaluation of the DPR (p=0.01); the data are given in Table 3. With age, GPs tended to think DPR is harmonious, as shown in Figure 2.
Table 1: Background characteristics of MPs and GPs.
Group
|
MPs (%)
|
GPs (%)
|
P
|
Gender
|
|
|
0.71
|
Male
|
56(36.36)
|
127(38.60)
|
|
Female
|
98(63.64)
|
202(61.40)
|
|
Age
|
|
|
0.21
|
≤25
|
34(22.08)
|
28(8.51)
|
|
26-35
|
83(53.90)
|
80(24.32)
|
|
36-45
|
13(8.44)
|
77(23.40)
|
|
46-55
|
22(14.29)
|
86(26.14)
|
|
≥56
|
2(1.30)
|
58(17.63)
|
|
MPs’ Education
|
|
|
|
Technical secondary school/college
|
10(6.49)
|
|
|
Undergraduate
|
57(37.01)
|
|
|
Master's degree
|
78(50.65)
|
|
|
PhD and above
|
9(5.84)
|
|
|
GPs’ Education
|
|
|
|
Elementary school and below
|
|
5(1.52)
|
|
Junior and high school
|
|
68(20.67)
|
|
Technical secondary school/college
|
|
88(26.75)
|
|
Undergraduate
|
|
126(38.30)
|
|
Postgraduate and above
|
|
42(12.77)
|
|
Place of residence
|
|
|
0.23
|
Village/township/town
|
21(13.64)
|
54(16.41)
|
|
County-level cities/prefecture-level cities
|
53(34.42)
|
90(27.36)
|
|
Provincial capital cities/Municipalities
|
80(51.95)
|
185(56.23)
|
|
Table 2. General population data of 154 MPs and the difference in the perception of the status of the doctor-patient relationship among groups. (TCM: Traditional Chinese Medicine; MM: Modern Medicine; ICWM: Integrated Chinese and Western Medicine Physician.)
Group
|
Harmony (%)
|
Normal(%)
|
Tense(%)
|
X2
|
P
|
Gender
|
|
|
|
0.01
|
0.995
|
Male
|
6(35.29)
|
35(36.46)
|
15(36.59)
|
|
|
Female
|
11(64.71)
|
61(63.54)
|
26(63.41)
|
|
|
Age
|
|
|
|
3.97
|
0.86
|
≤25
|
4(23.53)
|
21(21.88)
|
9(21.95)
|
|
|
26-35
|
7(41.18)
|
52(54.17)
|
24(58.54)
|
|
|
36-45
|
2(11.76)
|
7(7.29)
|
4(9.76)
|
|
|
46-55
|
4(23.53)
|
14(14.58)
|
4(9.76)
|
|
|
≥56
|
0(0.00)
|
2(2.08)
|
0(0.00)
|
|
|
Department
|
|
|
|
5.788
|
0.926
|
Internal Medicine
|
10(58.82)
|
46(47.92)
|
22(53.66)
|
|
|
Surgical
|
1(5.88)
|
20(20.83)
|
9(21.95)
|
|
|
Obstetrics and Gynecology
|
1(5.88)
|
3(3.13)
|
2(4.88)
|
|
|
Pediatrics
|
1(5.88)
|
5(5.21)
|
2(4.88)
|
|
|
Emergency department
|
0(0.00)
|
2(2.08)
|
0(0.00)
|
|
|
Medical Technology department
|
0(0.00)
|
4(4.17)
|
1(2.44)
|
|
|
Other auxiliary departments
|
4(23.53)
|
16(16.67)
|
5(12.20)
|
|
|
Years on the Job
|
|
|
|
8.645
|
0.373
|
≤5
|
10(58.82)
|
69(71.88)
|
31(75.61)
|
|
|
6-10
|
2(11.76)
|
6(6.25)
|
2(4.88)
|
|
|
11-20
|
1(5.88)
|
2(2.08)
|
4(9.76)
|
|
|
21-30
|
4(23.53)
|
16(16.67)
|
4(9.76)
|
|
|
≥31
|
0(0.00)
|
3(3.13)
|
0(0.00)
|
|
|
Job title
|
|
|
|
11.014
|
0.088
|
Primary
|
10(58.82)
|
71(73.96)
|
30(73.17)
|
|
|
Intermediate
|
5(29.41)
|
13(13.54)
|
5(12.20)
|
|
|
Deputy Senior
|
0(0.00)
|
6(6.25)
|
6(14.63)
|
|
|
Advanced
|
2(11.76)
|
6(6.25)
|
0(0.00)
|
|
|
Hospital type
|
|
|
|
1.715
|
0.788
|
TCM
|
12(70.59)
|
59(61.46)
|
24(58.54)
|
|
|
MM
|
3(17.65)
|
20(20.83)
|
7(17.07)
|
|
|
ICWM
|
2(11.76)
|
17(17.71)
|
10(24.39)
|
|
|
Hospital level
|
|
|
|
3.332
|
0.766
|
Community
|
2(11.76)
|
7(7.29)
|
2(4.88)
|
|
|
Level 2
|
2(11.76)
|
21(21.88)
|
8(19.51)
|
|
|
Level 3
|
12(70.59)
|
56(58.33)
|
28(68.29)
|
|
|
Other medical institutions
|
1(5.88)
|
12(12.50)
|
3(7.32)
|
|
|
Practice category
|
|
|
|
8.032
|
0.236
|
Nursing
|
0(0.00)
|
4(4.17)
|
2(4.88)
|
|
|
TCM physician
|
14(82.35)
|
68(70.83)
|
32(78.05)
|
|
|
MM physician
|
1(5.88)
|
11(11.46)
|
7(17.07)
|
|
|
ICWM physician
|
2(11.76)
|
13(13.54)
|
0(0.00)
|
|
|
Education
|
|
|
|
|
|
Technical secondary school/college
|
0(0.00)
|
7(7.29)
|
3(7.32)
|
9.707
|
0.138
|
Undergraduate
|
5(29.41)
|
41(42.71)
|
11(26.83)
|
|
|
Master's degree
|
9(52.94)
|
45(46.88)
|
24(58.54)
|
|
|
PhD and above
|
3(17.65)
|
3(3.13)
|
3(7.32)
|
|
|
Place of residence
|
|
|
|
3.38
|
0.496
|
Village/township/town
|
4(23.53)
|
11(11.46)
|
6(14.63)
|
|
|
County-level cities/prefecture-level cities
|
3(17.65)
|
35(36.46)
|
15(36.59)
|
|
|
Provincial capital cities/Municipalities
|
10(58.82)
|
50(52.08)
|
20(48.78)
|
|
|
Table 3. General population data of 329 GPs and the differences in the perception of the status of the DPR between groups.
Group
|
Harmony (%)
|
Normal(%)
|
Tense(%)
|
X2
|
P
|
Gender
|
|
|
|
1.695
|
0.428
|
Male
|
23(46.94)
|
71(36.98)
|
33(37.50)
|
|
|
Female
|
26(53.06)
|
121(63.02)
|
55(62.50)
|
|
|
Age
|
|
|
|
25.26
|
0.001
|
≤25
|
0(0.00)
|
16(8.33)
|
12(13.64)
|
|
|
26-35
|
4(8.16)
|
57(29.69)
|
19(21.59)
|
|
|
36-45
|
12(24.49)
|
44(22.92)
|
21(23.86)
|
|
|
46-55
|
16(32.65)
|
47(24.48)
|
23(26.14)
|
|
|
≥56
|
17(34.69)
|
28(14.58)
|
13(14.77)
|
|
|
Job type
|
|
|
|
15.394
|
0.052
|
Civil Service
|
16(32.65)
|
70(36.46)
|
20(22.73)
|
|
|
Private enterprise employees
|
17(34.69)
|
70(36.46)
|
42(47.73)
|
|
|
Self-employed
|
6(12.24)
|
21(10.94)
|
7(7.95)
|
|
|
Unemployed
|
10(20.41)
|
21(10.94)
|
10(11.36)
|
|
|
Student
|
0(0.00)
|
10(5.21)
|
9(10.23)
|
|
|
Education
|
|
|
|
13.57
|
0.094
|
Elementary school and below
|
3(6.12)
|
1(0.52)
|
1(1.14)
|
|
|
Junior and high school
|
10(20.41)
|
40(20.83)
|
18(20.45)
|
|
|
Technical secondary school/college
|
16(32.65)
|
45(23.44)
|
27(30.68)
|
|
|
Undergraduate
|
17(34.69)
|
80(41.67)
|
29(32.95)
|
|
|
Postgraduate and above
|
3(6.12)
|
26(13.54)
|
13(14.77)
|
|
|
Place of residence
|
|
|
|
5.188
|
0.269
|
Village/township/town
|
8(16.33)
|
32(16.67)
|
14(15.91)
|
|
|
County-level cities/prefecture-level cities
|
9(18.37)
|
50(26.04)
|
31(35.23)
|
|
|
Provincial capital cities/Municipalities
|
32(65.31)
|
110(57.29)
|
43(48.86)
|
|
|
Previous Hospitalization
|
|
|
|
4.217
|
0.121
|
Yes
|
47(95.92)
|
179(93.23)
|
87(98.86)
|
|
|
No
|
2(4.08)
|
13(6.77)
|
1(1.14)
|
|
|
3.2 Differences between the MP’s and the GP's perception of medical services
A total of 84 (54.55%) of the 154 MPs believed that the medical industry was a service industry, and 70 (45.45%) thought it was not. A total of 150 (97.4%) MPs thought that the service attitude of medical staff was as important as professional skills, and only 4 MPs (2.6%) considered it was not. While 234 (71.12%) of the 329 GPs thought that the medical industry was a service industry, 95 (28.88%) did not. Interestingly, 315 (95.74%) GPs thought that the attitude of medical staff is more important than professional skills and only 14 GPs (4.26%) considered it to be unimportant. The difference between MP and GP's perception of medical services is shown in Figure 3. Age, gender, department, years on the job, job title, hospital level, practice category, education and place of residence had no statistical significance for the MP's perception on whether the medical industry was a service industry (p>0.05); the data are shown in Table 4. Gender and prior hospitalization were statistically significant factors for the GPs' perception of whether the medical industry was a service industry. Education has statistical significance for GPs' perception of the importance of the service attitude of medical staff (p<0.05); the data are given in Table 5. The GPs' perception difference in service attitudes between medical staff and government staff/service staff is shown in Figure 4. Comparison of the service attitudes between the medical staff and the government staff shows that 45.15% of the GPs believed that the service attitude of both sectors was good in general, while 26.06% believed the service of the medical staff was better, and only 6.06% thought service attitude was bad in both sectors. A comparison of the service attitudes between the medical staff and the service staff showed that 41.25% of the GPs believed that the service attitude of the service staff was better, 17.58% thought that the medical staff was better, and only 1.52% thought both were bad.
Table 4. Differences in the MPs’ perception of medical services.
Is the medical industry a service industry?
|
Group
|
|
X2
|
P
|
Years on the Job
|
≤5/6-10/11-20/21-30/≥31
|
10.413
|
0.034
|
Hospital type
|
TCM/MM/ICWM
|
8.286
|
0.016
|
Table 5. Differences in the GPs' perception of medical services.
(a) Compared with professional skills, is the service attitude of medical staff important?
Group
|
|
X2
|
P
|
Gender
|
Male/Female
|
6.684
|
0.010
|
Previous Hospitalization
|
Yes/No
|
30.08
|
0.000
|
(b) Is the medical industry a service industry?
Group
|
|
X2
|
P
|
Education
|
Elementary school and below, Junior and high school, Technical secondary school/college, Undergraduate, Postgraduate and above
|
20.807
|
0.000
|
3.3 Differences in Perception between the MP and the GP on the medical industry
3.3.1 Differences in perception between the MP and the GP on medical industry income
Of the 154 MP respondents, 132 (85.71%) thought that medical staff did not earn high salaries, and only 22 (14.29%) thought they did. All factors such as age, gender, department, years on the job, job title, hospital level, practice category, education, and place of residence had no statistical significance for MP's cognition of the medical staff's income level, (P>0.05). Of the 329 GP respondents, 117 (35.56%) thought that medical staff did not earn high salaries, and 212 (64.44%) thought they did. Two factors, age and job type, have statistical significance for MP's cognition of the medical staff's income level (P<0.05); the data are given in Table 6. The difference between the MP and GP respondents’ perception of the medical staff's income level is shown in Figure 5.
Table 6. Differences in GPs’ perceptions of income from the medical industry
Group
|
|
X2
|
P
|
Age
|
≤25/26-35/36-45/46-55/≥56
|
10.874
|
0.028
|
Job type
|
Civil Service, Private enterprise employees, Self-employed, Unemployed, Student
|
10.213
|
0.037
|
3.3.2 Differences between MP and GP respondents in choosing whether their children are engaged in the medical industry
Of the 154 MP respondents, 74 (48.05%) did not want their children to be in the medical industry, and only 30 (19.48%) wanted that. In contrast, 155 (47.11%) of the 329 GP respondents wanted their children to be in the medical profession, and only 65 (19.76%) did not. The difference between the two in choosing whether they preferred their children to be in the medical industry is shown in Figure 6. Several factors, such as job title, education, perception of medical staff’s income, and what MPs prioritized to improve in routine medical work, were statistically significant for the MPs to choose whether they wanted their children to be in the medical industry (p<0.05); the data are shown in Table 7. Age, job type, cognition of medical staff's income level, perception differences in the DPR were statistically significant factors for the GP to choose whether they wanted their children to be in the medical industry (p<0.05); the data are given in Table 8. Among the 154 MPs, the most wanted to improve their salary (40.26%), followed by safety issues (17.53%); the improvement of the working environment was the least preferred factor (3.25%), as shown in Figure 7.
Table 7. Differences affecting MP's choice of whether their children are engaged in the medical industry.
Group
|
|
X2
|
P
|
Job title
|
Primary, Intermediate, Deputy Senior, Advanced
|
13.032
|
0.043
|
Education
|
Elementary school and below, Junior and high school, Technical secondary school/college, Undergraduate, Postgraduate and above
|
13.301
|
0.038
|
Whether medical staff belong to high-income groups.
|
Belong to/not belong to
|
12.318
|
0.002
|
MP's choice of what they want to improve in routine medical work.
|
Social status, Salary, Safety, Work time, Night shift frequency, Cumbersome hospital assessment, Doctor-patient relationship, Working environment
|
34.86
|
0.002
|
Table 8. Differences affecting the GP's choice of whether their children should be in the medical industry.
Group
|
|
X2
|
P
|
Age
|
≤25/26-35/36-45/46-55/≥56
|
19.371
|
0.013
|
Job type
|
Institution/Civil Service, Private enterprise employees, Self-employed, Unemployed, Student
|
25.104
|
0.001
|
Whether medical staff belong to high-income groups.
|
Belong to/not belong to
|
9.949
|
0.007
|
Current status of DPR.
|
Harmony /Normal/Tense
|
13.869
|
0.008
|