医师医疗责任保险购买意愿的影响因素调查研究  

Analysis of Influencing Factors for Intention of Doctors to Buy Medical Liability Insurance

作　　者：陈丽丽[1] 曹志辉[1] 李晶晶 臧春光 郑贺英[3] 吴迪[4] 

机构地区：[1]河北联合大学管理学院,河北省唐山市063000 [2]承德市医学院附属医院 [3]河北联合大学附属医院 [4]唐山市工人医院

出　　处：《中国全科医学》2015年第6期680-683,共4页Chinese General Practice

基　　金：国家自然科学基金资助项目(71373066);教育部人文社科基金项目(14YJAZH004)

摘　　要：目的调查医师医疗责任保险购买意愿的影响因素。方法 2014年3月,对承德医学院附属医院的400名在职医师进行问卷调查。共发放调查问卷400份,回收有效问卷375份,有效率为93.8%。采用自制调查问卷:包括一般情况问卷(包括性别、年龄等)、医疗责任风险程度问卷(包括医师近2年遭遇医疗纠纷的频率、赔付金额及各种损失等)、医疗责任保险意识问卷(包括对医疗责任保险制度的积极和消极评价)、现行医疗责任保险制度评价问卷(包括医师对医疗责任保险的保障范围、保费、赔偿额度、理赔程序等方面的评价)、医疗保险购买意愿问卷(包括医师购买医疗责任保险的意愿程度、优先考虑的因素等)。结果不同工作年限、职称和科室医师的医疗责任保险购买意愿比较,差异有统计学意义(P<0.05)。遭遇医疗纠纷医师愿意购买医疗责任保险率为66.2%(100/151),未遭遇医疗纠纷医师愿意购买医疗责任保险率为50.9%(114/224),差异有统计学意义(χ2=8.650,P=0.003)。愿意购买医疗责任保险医师的医疗责任保险意识得分为(32.1±5.1)分,不愿意购买医疗责任保险医师的医疗责任保险意识得分为(28.7±4.6)分,差异有统计学意义(t=6.670,P<0.001)。医师认为现行医疗责任保险制度存在的最主要的4个问题依次为:没有真正使医院和医师摆脱医疗纠纷(100.0%),承保范围有限(91.9%),医疗责任保险处理程序不完善/理赔过程复杂(87.2%),最高赔偿限额和免赔额设置不合理(65.1%)。结论医师的工作年限、职称和所在科室,医疗责任风险程度,医疗责任保险意识,医疗责任保险制度中存在的问题是医师医疗责任保险购买意愿的影响因素。Objective To investigate the influencing factors for the intention of doctors to buy medical liability insurance. Methods A total of 400 on- the- job doctors from the Affiliated Hospital of Chengde Medical College took part in a questionnaire survey in March 2014. 400 questionnaires were distributed and 375 were returned,with an effective rate of 93. 8%.Self- made questionnaires were used including questionnaires on general condition（ including sex and age,etc.）,risk level of medical liability（ including the frequency of medical liabilities over the past two years,compensation and losses）,awareness of medical liability insurance（ including positive and negative evaluation of medical liability insurance）,evaluation of the current medical liability insurance system（ including evaluation of the insurance coverage,insurance premium,compensation and claims settlement） and intention to buy medical liability insurance（ including the intention of doctors to buy medical liability insurance and priorities,etc.）. Results The intention to buy medical liability insurance of doctors with different years of working,professional titles and departments showed statistically significant differences（ P〈 0. 05）. 66. 2%（ 100 /151） of the doctors once involved in medical disputes were willing to buy medical liability insurance, while the ratio for doctors yet to be involved in medical disputes was 50. 9%（ 114 /224）, and the difference was statistically significant（ χ^2= 8. 650, P = 0. 003）. The awareness score of medical liability insurance for the doctors willing to buy the insurance was（ 32. 1 ± 5. 1）,while the score was（ 28. 7 ± 4. 6） for those who were not willing to buy the insurance,and the difference was statistically significant（ t = 6. 670,P〈 0. 001）. Doctors generally believed that there were four problems for the current medical liability insurance system： it could not get rid of medical disputes for hospitals and doctors（ 100. 0%）; limited insurance coverage（ 91

关 键 词：医师 保险 责任 购买意愿 影响因素 

分 类 号：R197[医药卫生—卫生事业管理]