浅议医疗责任险和医疗意外险  

Simply analysis of medical liability insurance and medical accident insurance

作　　者：李家鑫[1] 杨静[2] 

机构地区：[1]蚌埠医学院第一附属医院医患关系科,安徽蚌埠233004 [2]蚌埠医学院第一附属医院肿瘤内科

出　　处：《中华全科医学》2016年第1期136-139,共4页Chinese Journal of General Practice

摘　　要：多年来,我国不断研究、实践和改进国内外处理医疗纠纷的经验,总结教训,寻找一条富有中国特色的解决医疗纠纷的机制。如今,我国从理论到实践在全国范围内全面推广医疗纠纷处理的第三方调解机制,全国各地纷纷建立"医患纠纷调解委员会",为医患双方打造了解决纠纷的平台,很大程度上缓解了医患矛盾。同时,为配合和完善第三方调解机制的运行,多年来在全国各地对医疗责任保险作尝试推行,从失败中总结经验教训,不断完善险种和条款,与第三方调解机制相互配合。医疗责任保险对于"医患纠纷调解委员会"工作的开展已不仅仅是配套辅助作用,而是起到重要的支撑作用,缺少了医疗责任保险,第三方调解机制名存实亡。保险公司、医疗机构、医患纠纷调解委员会形成了一个稳定的三角支撑起第三方调解机制的顺利运行。随着医疗责任保险在全国的推广,医疗责任险的优势和不足也在逐渐显现,为了补充医疗责任险的不足,医疗意外险逐渐出现在国家政策层面和民众眼前,不少地方已经开始实践医疗意外险。医疗意外险对于医疗责任险的补充作用也越来越受到重视和关注。医疗意外险配合医疗责任险完善并支撑了第三方调解机制,使得第三方调解机制越发的富有生命力,能更好地化解医患矛盾。For many years, China summarize constantly the experiences through researching, practicing and improving the cases of medical disputes at home and abroad, and has got a new mechanism to solve medical disputes with Chinese char- acteristics. Today, the third-party mediation mechanism for solving medical disputes has been spread nationally from theory to practice, and lots of doctor-patient dispute mediation committees, which are the platform for solving medical disputes, were found across the country. These committees can greatly relieve the contradiction of doctor and patient. At the same time, the medical liability insurance, which aims to cooperate and improve the operation of the third party mediation mech- anism, has also been spread tentatively for many years in a nationwide. Lots of experience and improved insurance clauses were obtained from failure. Medical liability insurance is not only an auxiliary, but also play an important supporting role for the doctor-patient dispute mediation committee＇ s work. Lacking of the medical liability insurance, the third party medi- ation mechanism exists in name only. A stable triangle has been formed form insurance company, medical institution and medical disputes mediation committee, and this triangle can ensure that the third-party mediation mechanism run success- fully. With the spreading of medical liability insurance in national scope, the advantages and disadvantages of medical lia- bility insurance have been gradually revealed. In order to compensate the weakness of medical liability insurance, acciden- tal medical insurance comes up as a supplement. A few of local governments have practiced the accidental medical insur- ance, and accidental medical insurance has become more important as supplement. Accidental medical insurance and med- ical liability insurance support the third party mediation mechanism, and make the third party mechanism full of vitality, and can solve doctor-patient conflicts effectively.

关 键 词：医疗意外险 医疗责任险 医疗纠纷 

分 类 号：R197.323.4[医药卫生—卫生事业管理]