Trends in Workplace Violence Involving Health Care Professionals in China from 2000 to 2020: A Review

Abstract

The safety of health care workers in China has received an increasing amount of attention owing to numerous incidents of hospital-based violence against medical professionals. When pictures and videos of violent injuries are posted on the internet with real-time data, such as gender or location, researchers can access the information to learn about the incident, its causes, and/or threats to survival. We examined the causes and risk factors for workplace violence by analyzing relevant data retrieved from reports by Chinese internet media for all incidents from 2000 to 2020. We present frequency data on hospital-based violence against medical professionals. A total of 345 incidents occurred in health care settings. The person who committed the violent act was a patient or sick person in the workplace or a co-worker in 95.4% of the incidents; 54 of the incidents resulted in the victim's murder. We provide the characteristics and risk factors of violent criminals. We describe China's past and current clinical practices and health care policies, and we discuss the challenges faced by medical professionals who are victims of hospital-based violence from the perspectives of patients, physicians, hospital leaders, and the government. We conclude by making recommendations for preventing violence in hospital settings. It is urgent for the public to understand that the occupational safety of health care workers must be protected, and treatment should be provided to patients in a harmonious and safe environment. This review aims to describe the trends in workplace violence involving health care professionals in China from 2000 to 2020 and to discuss possible strategies for improving working conditions in hospitals and other health care settings.

Figure 1

Violence-related injuries sustained by China’s health care workforce.

Figure 2

(A, B) Causes of hospital-based violence against medical personnel: a) overtesting of the patient by the hospital; b) misdiagnosis and delays; c) poor outcomes or sequelae; d) medical identification; e) sexual harassment; f) the health care worker’s choice of technology, diagnosis, or guidance; g) hospital charges; h) medical staff’s bearing; i) objective factors (such as provision, insufficient medical resources); j) death of the patient; k) mental state; l) absence of a valid diathesis; m) psychological distortion; n) other reasons (injury-related irritation, blackmail, or asking private questions); o) unknown reasons; p) a+b+c+d+e+f=communication; q) g+h+i=service.

Figure 3

(A, B) The proportion of each cause of hospital-based violence. The causes of workplace violence and their representative letters (a–q) are the same as those reported in Figure 2.

Figure 4

China’s health expenditures (A) and per capita rural (B) and urban (C) distributions of consumption expenditures. Data are from the National Bureau of Statistics [44] and the National Health Commission [47].