美英加澳和中国台湾地区医疗风险管理机构、法规与运行机制的比较研究  

Comparative Analyses of Institutions,Regulations and Administration on Healthcare Risk Management in United Kingdom,United States,Canada,Australia and Taiwan District

作　　者：孙纽云[1] 王莉[2] 周军[3] 袁强[2] 张宗久[3] 李幼平[2] 梁铭会[1] 成岚[2] 高光明[3] 崔小花[2] 

机构地区：[1]卫生部医院管理研究所,北京100083 [2]四川大学华西医院中国循证医学中心,成都610041 [3]卫生部医疗服务监管司,北京100044

出　　处：《中国循证医学杂志》2011年第2期117-124,共8页Chinese Journal of Evidence-based Medicine

摘　　要：目的 "医疗风险无处不在"已成为全球医疗界的共识。有关病人安全的文献量和报告数都在快速增长,但对其概念的解读和比较尚缺乏共识。本研究通过比较美英加澳和我国台湾地区医疗风险管理的概念、政策法规、机构管理和运行机制等,为我国医疗风险管理提出决策依据和政策建议。方法计算机检索美国、英国、加拿大、澳大利亚和我国台湾地区政府机构和行业协会或学术团体的官方网站,纳入其医疗风险管理与监测的相关法律、规范性文件、研究报告、综述和评价表格的文献,按法律法规、规范性文件或指南、综述和一般信息分类分级,并采用描述性对比分析方法,系统比较其风险管理机构、法规和运行机制。结果①共纳入146篇文献,包括2篇法律法规,17篇规范性文件,41篇指南,37篇综述和49篇一般信息;②上述四国一区中仅美国颁布了2部病人安全的法律,仅英国和澳大利亚各发布了1个病人安全指南;③四国的病人安全管理机构设置均为国家、州/省/地区、医院和NGO或其他机构(协会)等四级结构管理、协同工作。结论①四国一区中,仅美国以法律的形式为病人安全与医疗管理提供法律保障,英国和澳大利亚卫生部以行业指南的形式为病人安全提供政策保障。②四国一区的病人安全机构设置均为中央、地方、机构和NGO四级结构,运行机制大致分为以美国、加拿大为代表的非政府组织主导协同工作,和以英国、澳大利亚为代表的国家政府主导的两种模式。我国台湾地区病人安全管理机构属于地方二级机构。Objective Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language.This series of articles aims to comprehensively compare laws and regulations,institutional management,and administration of incidence reporting systems on medical risk management in the United Kingdom,the United States,Canada,Australia,and Taiwan,so as to provide evidence and recommendations for health care risk management policy in China.Methods We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws,regulatory documents,research reports,reviews and evaluation forms concerned with healthcare risk management and assessment.Descriptive comparative analysis was performed on relevant documents.Results A total of 146 documents were included in this study,including 2 laws（1.4%）,17 policy documents（11.6%）,41 guidance documents（28.1%）,37 reviews（25.3%）,and 49 documents giving general information（33.6%）.The United States government implemented one law and one rule of patient safety management,while the United Kingdom and Australia each issued professional guidances on patient safety improvement.The four countries implemented patient safety management policy on four different levels： national,state/province/district,hospital,and non-governmental organization.Conclusion The four countries and one district adopted four levels of patient safety management,and the administration modes can be divided into an ＂NGO-led mode＂ represented by the United States and Canada and a ＂government-led mode＂ represented by the United Kingdom,Australia,and Taiwan.

关 键 词：病人安全 医疗风险管理 法律法规 

分 类 号：R199[医药卫生—卫生事业管理]