对于医疗卫生服务市场化究竟会改善还是恶化医患关系，以往研究并未给出清晰的答案。基于增加竞争者组织密度的视角，本研究利用中国社会状况综合调查数据考察了民营医院发展水平对患者信任的影响及其机制。研究发现，各省民营医院发展水平与患者信任的关系呈现“U型”效应。各省民营医院发展水平较低会对患者信任产生削弱效应；当其迈入高水平后，则会促进患者信任。此外，当各省民营医院发展水平较高时，会通过对整个医疗卫生服务行业的“提质降费”作用机制来正向影响患者信任。总之，本研究在一定程度上检验了民营医院发展的“鲶鱼效应”，也为医患信任的制度主义解释路径提供了新的角度。

Previous studies have failed to provide a definitive answer on whether the marketization of healthcare will improve or deteriorate the relationship between doctors and patients. Based on the perspective of increasing the organizational density of competitors, this study uses the data of Chinese Social Survey to examine how development levels of private hospitals impact patient trust. The study reveals that the relationship between the development of private hospitals and patient trust in each province shows a " U-shaped" effect. This means that when the development level of private hospitals in a province is low, it tends to weaken patient trust; however, once it reaches a high level, it will enhance patient trust. In addition, at the stage of high development level of private hospitals in various provinces, they positively impact on patient trust through the mechanism of improving the quality of medical services and reducing overall healthcare costs. In summary, this study examines the "catfish effect" of private hospital development and provides a new perspective for the institutionalist explanation of doctor-patient trust.

本研究得到国家社会科学基金重点项目“城乡居民的数字健康素养研究”（23ASH012）的支持。

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