患方对医疗纠纷第三方调解模式的认知调查  

Survey on Patients' Cognition of Third-party Mediation Model for Medical Disputes

作　　者：曾达[1] 刘珂 夏勇军[1] 董贺文 金伟[1] 刘敏[1] 

机构地区：[1]四川大学华西基础医学与法医学院,成都610041 [2]新津县兴义镇人民政府

出　　处：《华西医学》2016年第5期905-912,共8页West China Medical Journal

摘　　要：目的通过问卷调查的方式,针对医疗纠纷第三方调解模式,了解患者对其认知和选择倾向,分析患者对其信任程度的影响因素并提出促进其完善和发展的相关建议。方法 2013年11月-2014年4月参照既往有关文献资料,设计相关问题,制作《医疗纠纷第三方调解认知调查问卷》,对因伤病经住院治疗终结的患者进行整群随机抽样调查。将所得原始数据逐条录入计算机建立数据库,以SPSS 18.0软件对数据进行统计分析。结果共发放问卷500份,回收有效问卷486份。患者对第三方调解的知晓程度较高,知道者占61.52%。55.35%的患者认为调解应在法院进行并由法院主管;57.41%的患者选择在调解失败后通过司法途径继续解决纠纷;67.90%的患者倾向于以仲裁形式确认调解结论的效力。70.58%的患者认为调解人员应具备医学以及法学的专业背景,73.05%的患者倾向于采用司法鉴定的结论作为调解依据,此外,64.81%的患者倾向于适用《侵权责任法》作为确定赔偿的法律依据。53.70%的患者认为第三方调解应由财政拨款解决经费问题,38.48%的患者认为应由保险公司支付;同时,91.15%的患者认为医疗机构应该购买医疗责任险,且54.32%的患者认为保险公司不宜提前介入医疗纠纷的调解过程。结论应由政府财政拨款来保障第三方调解机构的经费,同时引入医疗责任险予以补充。医疗机构应购买医疗意外保险,解决无过失医疗损害引起的医疗纠纷的赔偿问题。第三方调解的调解地点应与法院或司法行政部门衔接,同时由法院或司法行政部门负责管理。调解员应由具备医学和法学知识的专业人员共同组成,并加强专业人才的培养、提高调解员的工作能力与服务水平。应选择医疗纠纷司法鉴定结论作为调解的依据,同时推动全国医疗纠纷仲裁制度的建立和发展。Objective To understand patients＇ cognition of third-party mediation model for medical disputes,analyze the factors influencing the trust of patients on third-party mediation,and propose recommendations for building third-party mediation mechanisms.Methods From November 2013 to April 2014,we referred past literature to design a relevant questionnaire on the cognition of third-party mediation for medical disputes.Patients who had reached the end of the treatment were surveyed by random cluster sampling.The raw data were put into the computer for statistical analysis by SPSS 18.0.Results After giving out 500 questionnaires,we acquired 486 effective questionnaires.The result showed that 61.52%of the patients knew of third-party mediation;55.35%of the patients considered that thirdparty mediation should be set in and supervised by the court or judicial administrative department;if the mediation failed,57.41%of the patients chose to resolve the dispute through legal channels,and 67.90%of the patients tended to confirm the force of mediation conclusion by arbitration;70.58%of the patients considered that mediators should have professional background of medicine and law;73.05%of the patients tended to take conclusions of forensic identification as the basis for mediation;64.81%of the patients were biased to take Tort Liability Act as the basis for determining the compensation;53.70%of the patients believed that financial allocations could solve the fund problems of third-party mediation,while 38.48%of the patients thought the funds should be provided by insurance companies;91.15%of the patients thought the medical institutions should purchase medical liability insurance,and 54.32%of the patients thought insurance companies should not intervene the process of meditation.Conclusions Government should provide financial allocations to ensure the funds of third-party mediation.Besides,medical insurance should be brought in as a supplement.Medical institutions should purchase medical liability insurance to solve problems ca

关 键 词：医疗纠纷 第三方调解模式 问卷调查 医疗责任险 非诉讼解决 

分 类 号：R-051[医药卫生]