title: Managing patient complaints in China: a qualitative study in Shanghai.
abstract: OBJECTIVE
  To examine the handling system for patient complaints and to identify existing barriers that are associated with effective management of patient complaints in China.
  
  
  METHODS
  Key stakeholders of the handling system for patient complaints at the national, Shanghai municipal and hospital levels in China.
  
  
  METHODS
  35 key informants including policymakers, hospital managers, healthcare providers, users and other stakeholders in Shanghai.
  
  
  METHODS
  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.
authors.affiliation: School of Public Health, Fudan University, Shanghai, China Shanghai Maternal and Child Health Center, Shanghai, China.
authors.forename: Yishi
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: School of Public Health, Fudan University, Shanghai, China.
authors.forename: Xiaohua
authors.initials: X
authors.lastname: Ying
authors.affiliation: School of Public Health, Fudan University, Shanghai, China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhang
authors.affiliation: School of Public Health, Fudan University, Shanghai, China.
authors.forename: Sirui Rae
authors.initials: SR
authors.lastname: Tang
authors.affiliation: KIT Development Policy & Practice, Royal Tropical Institute, Amsterdam, The Netherlands.
authors.forename: Sumit
authors.initials: S
authors.lastname: Kane
authors.affiliation: KIT Development Policy & Practice, Royal Tropical Institute, Amsterdam, The Netherlands.
authors.forename: Maitrayee
authors.initials: M
authors.lastname: Mukhopadhyay
authors.affiliation: School of Public Health, Fudan University, Shanghai, China.
authors.forename: Xu
authors.initials: X
authors.lastname: Qian
mesh_terms: D002681:China; D006739:Hospital Administration / Q000379:methods*; D006801:Humans; D007407:Interviews as Topic; D017060:Patient Satisfaction; D036301:Qualitative Research; D013222:State Medicine; D011795:Surveys and Questionnaires
keywords: HEALTH SERVICES ADMINISTRATION & MANAGEMENT; QUALITATIVE RESEARCH