基于情境技术的医方处理方法对患者处置行为影响因素的探讨  

Medical Malpractice and Hospitals' Response:A Patients' Perspective

作　　者：刘东兴 谢铮[2] 陈乂恿 闫镝[2] 郜凯华[2] 李楠[2] 张拓红[2] 

机构地区：[1]解放军二炮总医院,北京100088 [2]北京大学公共卫生学院卫生政策与管理学系,北京100191

出　　处：《中国卫生质量管理》2011年第5期69-72,共4页Chinese Health Quality Management

基　　金：首都医学发展基金资助;项目编号2007-3030

摘　　要：目的了解患者在遭遇医疗纠纷时的应对行为,并探讨院方的处理策略。方法使用自行设计的案例调查工具(Vignette问卷),对北京市5家医院的500名患者进行问卷调查。结果患者在处理医疗纠纷时多选择向医院投诉解决,并希望得到尽快回复。在医疗纠纷中,医院"承担部分责任"的回复最令患者满意;当责任主要在医院时,患者更倾向于向法院投诉寻求解决;2个场景中选择"找家人朋友来医院讨公道"的比例不足5%,且差异不具有统计学意义(P<0.05);患者接受医院回复的原因在于医院做出的解释合理且态度诚恳。肿瘤误诊案例中,患者期望的赔偿金额高于病人摔倒骨折案例。结论医院的态度及处理方式对患者应对医疗纠纷的行为有重要影响;患者期望的赔偿金额与患者遭遇的严重程度和医院责任的比例有关。Objective To understand the patient＇s logical behavior when faced with medical malpractice and explore the proper approaches for hospitals. Method From five different hospitals, 500 patients were surveyed using self - designed case tools （ Vignette questionnaire ）. Result When dealing with medical malpractice, patients tended to continuously complaint to hos- pitals to seek a solution, and hoped to get early response. When faced with medical malpractice, they were most satisfied with the response that the hospital had made detailed explanations, comforted, apologized, and promised to share a small part of medical expenses; When hospitals beard the main responsibility, Patients tended to appeal to the court to seek a solution, while the ratio of patients who choose to make trouble with the hospital was less than 5% and there was no statistically significant between the two situations. The expected monetary compensation in Case one was significantly higher than the other. Conclusions Whether pa- tients are satisfied with the attitude and solutions of hospitals is a significant factor in the development of medical malpractice. Hospitals should give reasonable explanations, account for their action, comfort patients and share some medical expenses; Pa- tients severity of suffering and the ratio of the responsibility are predictive of the monetary compensation.

关 键 词：情境技术 医疗纠纷 患者行为逻辑 

分 类 号：R197.3[医药卫生—卫生事业管理]