Patient views and attitudes to physician's actions after medical errors in China

J Patient Saf. 2012 Dec;8(4):153-60. doi: 10.1097/PTS.0b013e318257ffa0.


Objectives: To explore Chinese patients' views on physician disclosure actions after an adverse event and their acceptance of different types of apologies from the physician who caused the event.

Methods: A questionnaire survey was conducted in 2009, collecting 934 valid responses (52% response rate) from inpatients and families in 3 Chinese hospitals. Respondents' views on and attitudes toward physician actions after a medical error were elicited as responses to 2 fictitious adverse events (vignettes) with different levels of outcome severity.

Results: Chinese patients were more skeptical of physician disclosure actions after a case with a severe outcome than with a mild outcome. Recent experiences of suffering due to medical errors deteriorated patients' trust in physician disclosure actions. Chinese patients would prefer to receive a "full" apology, which included explicit words of apology and an undertaking of hospital responsibility. The results revealed the most effective apology, which was a full apology with the hospital's promise of taking preventive actions, and the least effective apology, a so-called "partial" apology in which the physician merely expresses sympathy for the event. Patient refusal of a physician's apology became stronger with an increase in the level of outcome-mild versus severe.

Conclusions: Chinese patients' suspicion about health-care staff disclosure actions is rather strong. In addition, a large difference was identified in the level of patient acceptance between a physician's "full" or "partial" apology. Therefore, it is suggested that Chinese hospitals should adopt an "open" policy, which should include a "sincere" apology to the patient who experienced a medical error to maintain mutual trusts between the staff and patients.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Attitude to Health*
  • China
  • Female
  • Humans
  • Male
  • Medical Errors / psychology*
  • Medical Errors / statistics & numerical data
  • Middle Aged
  • Perception*
  • Physician-Patient Relations
  • Physicians*
  • Surveys and Questionnaires
  • Truth Disclosure*