117例医疗纠纷成因的帕累托图分析  

The Reason Analysis of Medical Disputes by Using Pareto Diagram

作　　者：唐建中[1] 姚小康[1] 胡笑甜[2] 刘英[2] 徐卫琼[2] 郑福云[2] 

机构地区：[1]云南省第一人民医院,云南昆明650031 [2]昆明医科大学,云南昆明650500

出　　处：《昆明医科大学学报》2015年第3期41-44,共4页Journal of Kunming Medical University

基　　金：云南省教育厅科学研究基金重点项目(2011Z064)

摘　　要：目的探索医院内医疗纠纷的发生及原因,以把握医疗纠纷的发展规律,为医院管理者有效控制医疗纠纷提供参考依据.方法应用根本原因分析法找出医疗纠纷的根本原因,运用帕累托图法对117例缺陷原因进行排序,明确最需要解决的问题.结果从医疗纠纷的学科分布来看,外科发生的医疗纠纷数量和发生率均为最高,儿科最低.在所有医疗纠纷案例中,业务能力缺陷、并发症和医疗意外、制度规范不严格执行的累积百分比在36.7%-69.9%之间,是主要因素;治疗或抢救不及时的累积百分比为83.5%,是次要因素;诊疗效果不佳、管理环节疏漏的累积百分比在95.9%-100%之间,是一般因素;业务能力缺陷、并发症和医疗意外、制度规范不严格执行是导致医疗纠纷的主要原因.结论医院应通过多种途径来提高医务人员技术水平,增强医务人员的临床业务能力,严格各科室执行规章制度,以便灵活的应对各种并发症和医疗意外,进而防止或控制医疗纠纷的发生.Objective To find out the reasons of medical disputes, grasp the regulation of medical disputes,and provide references for the control of medical malpractice for hospital managers. Method Pareto diagram was used to find out the main reasons,and then made clear the most urgent problems to be solved.Results The number and rate of medical disputes in surgical department were the highest,and the ones of pediatrics were the lowest. Form the pareto diagram of 117 medical disputes, the cumulative percent of medical professional ability defects, complications and medical accidents, the shortage of occupational morality was 36.7%-69.9%,these three reasons were foremost. The cumulative percent of not timely treatment and rescue was 83.5%,this reason was secondary. The cumulative percent of poor treatment and management oversight link was 95.9-100%,these reasons were generally. The main reasons of medical disputes were medical professional ability defects,complications and medical accidents, the shortage of occupational morality.Conclusion To control of medical disputes, hospitals should take the following measures in practice： improve the technical level of medical staff, enhance the capacity of medical staff, enforce rules and regulations strictly and deal with the complications and medical accidents flexibly.

关 键 词：医疗纠纷 原因分析 帕累托图 

分 类 号：R197.3[医药卫生—卫生事业管理]