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

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.

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.

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.

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.