The weakness of the strong: Examining the squeaky-wheel effect of hospital violence in China

Abstract Hospital violence has become a worldwide issue that disturbs health care systems. China is in a particular dilemma between meeting the healthcare demand of 1.39 billion residents and ensuring the safety of 12.3 million health professionals. Drawing on data from an administrative survey, we first presented the types and distribution of disruptive behaviors, as well as the summary statistics of 225 medical disputes that took place from 2012 to 2013 in Z city. Logit and OLS regression analyses show that disruptive behaviors, characterized by the number of protest participants and the length of protest, can significantly predict whether the claimant receives compensation and the amount of compensation. All else equal, a one-person increase in the number of participants is associated with 3.94% higher odds of getting compensated, whereas a one-day increase in the length of protest is associated with a 1.03% increase in the odds of receiving compensation. Further analyses show that the link between disruptive behaviors and compensation outcomes is due to the involvement of the state, which tends to press hospitals to pay when substantial violence is present. Chinese government's overwhelming emphasis on social stability gives protestors leverage against hospitals, which can be summarized as “the squeaky wheel gets the grease.” Ironically, the sensitivity of Chinese government towards social stability becomes a weakness of its own. Government's active intervention to reach a peace-oriented goal will incentivize patients to resort to violence in pursuit of compensation. This study has implications for understanding Chinese government's logic of addressing social problems that range from hospital violence, labor disputes, land disputes to demolition compensation and civil petitions.