基于临床路径的医师防御性医疗行为测量与分析  

Measurement and Analysis of Defensive Medicine Behavior of Physicians Based on Clinical Pathway

作　　者：曹志辉[1,2] 吴明[1] 

机构地区：[1]北京大学公共卫生学院,北京100083 [2]河北联合大学管理学院,河北唐山063000

出　　处：《中国医院管理》2014年第9期12-14,共3页Chinese Hospital Management

基　　金：国家自然科学基金项目(71373066);河北省高等学校社科研究2012年度基金项目(SQ121012)

摘　　要：目的提出具有较高可行性、效度和信度的防御性医疗行为测量工具和方法,了解医师防御性医疗行为的类型、数量和分布。方法以河北省某医院的110例脑出血住院患者为例,以临床路径为基础,应用病历回顾性评判法对医师的防御性医疗行为进行测量和分析。结果医师采取了多种类型的防御性医疗行为,内科治疗和外科手术治疗患者的防御性医疗分别占全部检查化验费的24.6%和21.1%。结论研究提出的防御性医疗行为测量方法具有较高的科学性,但仍需进一步完善;医疗纠纷和诉讼压力导致医师产生了各种类型的防御性医疗行为,而且较为程度较为严重。Objeclive To develop DM behavior measuring toot and method with high feasibility, validity and reliabili- ty, and describe the species, quantities and distribution of DM. Method Through taking 110 patients with cerebral hemorrhage as an example and based on Clinical Pathway, measuring and analyzing physicians＇ DM behavior through retrospective evaluating method. Result Various kinds of DM were conducted by physicians. DM in conservative treat- ment and surgical treatment respectively accounts for 24.6% and 21.1% in total expenditure of laboratory examina- tions. Conclusion DM behavior measuring tool and method proposed by the study is rather scientific, but it needs to be improved. Facing the increasing pressure of medical disputes and litigation, physicians have generally adopted de- fensive medicine, and the levels of DM are relative high.

关 键 词：临床路径 防御性医疗 病历回顾性评判 

分 类 号：R197.3[医药卫生—卫生事业管理]