Managing patient complaints in China: a qualitative study in Shanghai

OBJECTIVES To examine the handling system for patient complaints and to identify existing barriers that are associated with effective management of patient complaints in China. SETTING Key stakeholders of the handling system for patient complaints at the national, Shanghai municipal and hospital levels in China. PARTICIPANTS 35 key informants including policymakers, hospital managers, healthcare providers, users and other stakeholders in Shanghai. PRIMARY AND SECONDARY OUTCOME MEASURES Semistructured interviews were conducted to understand the process of handling patient complaints and factors affecting the process and outcomes of patient complaint management. RESULTS The Chinese handling system for patient complaints was established in the past decade. Hospitals shoulder the most responsibility of patient complaint handling. Barriers to effective management of patient complaints included service users' low awareness of the systems in the initial stage of the process; poor capacity and skills of healthcare providers, incompetence and powerlessness of complaint handlers and non-transparent exchange of information during the process of complaint handling; conflicts between relevant actors and regulations and unjustifiable complaints by patients during solution settlements; and weak enforcement of regulations, deficient information for managing patient complaints and unwillingness of the hospitals to effectively handle complaints in the postcomplaint stage. CONCLUSIONS Barriers to the effective management of patient complaints vary at the different stages of complaint handling and perspectives on these barriers differ between the service users and providers. Information, procedure design, human resources, system arrangement, unified legal system and regulations and factors shaping the social context all play important roles in effective patient complaint management.