某市167例法院受理医疗损害责任案例成因分析与防范  

Causes and Ways of Prevention of 167 Cases of Medical Malpractice Liability Accepted by Court in a City

作　　者：慕媛 韩晨光[2] 

机构地区：[1]天津中医药大学研究生院,天津300073 [2]武警后勤学院附属医院

出　　处：《解放军预防医学杂志》2017年第4期359-362,共4页Journal of Preventive Medicine of Chinese People's Liberation Army

基　　金：天津市医院协会医院管理项目(No.2015zch16)

摘　　要：目的探讨医疗行为不当所致医疗损害的成因及防范对策。方法回顾性分析某市2006-2016年167例法院公示的医疗损害责任案例,从司法视角探讨医疗行为不当所致医疗损害的成因、责任界定及赔付原因。结果三级医院出现的医疗损害责任纠纷案件多于一、二级医院,外科出现的概率偏高;由医学会开展的医疗损害鉴定其确认医院有因果关系的比例(68.97%)低于司法鉴定者(95.65%),两组之间存在显著性差异(P<0.01);外科操作不当、侵犯患方知情权、漏诊、病历质量缺陷、误诊误治是导致医疗纠纷的主要原因。结论加强围术期并发症的防控,保护患方知情同意权和隐私权,防范误诊漏诊,持续加大院、科两级质控管理力度,健全医疗安全与风险管理体系,基于信息化平台织密医疗质量督查与医疗安全风险防控网,是降低医疗损害责任纠纷的关键。Objective To explore the causes and preventive measures of medical damage caused by medical malpractice.Methods 167 cases of medical damage liability made public by the court between 2006 and 2016 in a city were analyzed retrospectively.The causes of these cases,definitions of liability and the reasons for payment of medical malpractice were explored from the judicial perspective.Results There were more cases related to damage liability disputes in tri-grade hospitals than in those at a lower level,and departments of surgery were the most vulnerable.More medical damage appraisals were conducted by forensic doctors（95.65%）than by the Medical Association（68.97%）,and there was significant difference between the two groups（P〈0.01）.The main causes of medical disputes were Improper operations,infringement on the right to know,missed diagnosis,quality defects of medical records,misdiagnosis and mistreatment.Conclusion To strengthen the control of perioperative complications,protect patients＇right to informed consent and privacy,prevent misdiagnosis and missed diagnosis,implement two-level quality control management,improve the system of risk management,and enhance surveillance based on the information platform are the key to reducing medical damage liability disputes.

关 键 词：法院 医疗损害 案例 成因 防范 

分 类 号：R197.323[医药卫生—卫生事业管理]