医患风险影响因子体系构建及实证分析  

Construction and Empirical Analysis of the Influencing Factors System of Doctor-patient Risk

作　　者：孙江洁[1,2] 张利萍 张琦琦[3] 张华 姜园园 王平 何成森 SUN Jiangjie;ZHANG Liping;ZHANG Qiqi;ZHANG Hua;JIANG Yuanyuan;WANG Ping;HE Chengsen(Health Management College,Anhui Medical University,Hefei 230032,China;Clinical Medical College,Anhui Medical University,Hefei 230601,China;School of Management,University of Science and Technology of China,Hefei 230032,China)

机构地区：[1]安徽医科大学卫生管理学院,合肥230032 [2]中国科学技术大学管理学院,合肥230009 [3]安徽医科大学临床医学院,合肥230601

出　　处：《安徽广播电视大学学报》2018年第4期7-12,共6页Journal of Anhui Radio & TV University

基　　金：四川省教育厅人文社会科学重点研究基地--西南大学四川医院管理与发展研究中心课题"安徽地区三甲医院医德医风现状调查及对策"(项目编号:SCYG2018-10);国家社会科学基金项目(项目编号:14BGL141);安徽省教育厅自然科学重点研究基金项目(项目编号:KJ2016SD30);安徽省质量工程项目(项目编号:2016jyxm0552);安徽省大学生创新创业训练项目(项目编号:201710366101;201710366055);安徽医科大学思政课题(项目编号:2017xszh07;2017xszh16)

摘　　要：针对当前紧张的医患局面,通过分析国内医患冲突事件和调查医患关系的现状,采用Delphi方法,确定影响医患风险的68个因子并实证分析,进而构建医患风险影响因子体系,最后提出了"落实财务导向型医患风险管理机制""科学、合理组建医院医患关系管理部门""建立定额动态调整医保支付方式""倡议在公立医院建立患者/家属健康数据联动,公立医院患者就医身份认定制度,实施分诊治疗""在公立医院构建医患风险管控三级系统,提出行为经济学视角下的医患关系管控‘培训常态化、运作规范化和管理制度化’"等五点建议,降低医患风险,改善医患关系。In view of the current tense situation of doctors and patients and through analyzing the current situation of doctor patient conflict and investigating the status quo of doctor patient relationship, Delphi method is used to determine the 68 factors affecting the risk of doctor patient and an empirical analysis is done, followed by the construction of a doctor patient risk factor system. Finally, it put forward five suggestions： the implementation of finance oriented risk management mechanism for doctors and patients, scientific and rational organization of the doctor patient relationship management departments in hospitals, the establishment of dynamic adjustment of the amount of medical insurance payment methods, and the initiative to establish patient as well family health data linkage in public hospitals, public hospital patient identification system for medical treatment, implementation of triage treatment, the establishment of a three tier system of doctor patient risk management and control in public hospitals which prowides training normalization, operation standardization, and management institutionalization for doctor patient relationship control from the perspective of behavioral economics. With the five suggestions mentioned above, it is expected to reduce the doctor patient risk and improve the doctor patient relationship.

关 键 词：医患风险 影响因子 DELPHI方法 结构方程 

分 类 号：C93[经济管理—管理学] R197.3[医药卫生—卫生事业管理]