基于服务差距模型的医疗纠纷现状  

Current Status of Medical Disputes Based on Service Gap Model

作　　者：刘宇[1] 冷峰 施文大 胡国勇[1] LIU Yu;LENG Feng;SHI Wenda;HU Guoyong(Department of Medical Affairs,Shanghai Gen-eral Hospital,Shanghai 200080;Department of Medical Affairs,Second Affiliated Hospital of Naval Medical University,Shanghai 200080;Office of Journal,the Affiliated Hospital of Yangzhou Universi-ty,Yangzhou 225000)

机构地区：[1]上海市第一人民医院医务处,上海200080 [2]海军军医大学第二附属医院医务处,上海200080 [3]扬州大学附属医院院志办公室,扬州225000

出　　处：《解放军医院管理杂志》2021年第7期656-658,共3页Hospital Administration Journal of Chinese People's Liberation Army

基　　金：国家社会科学重大招标项目:和谐医患关系的心理机制与促进系统构建(17ZDA327)。

摘　　要：目的通过对上海八家医院近三年发生的医疗纠纷案例中医患双方有关情况进行分析,探析医疗纠纷的成因,结合服务差距模型提出针对性的建议。方法分层整群抽取上海八家医院524例医疗纠纷案例,采用问卷调查法、描述性统计方法对纠纷发生的科室分布和医疗纠纷的成因进行分析。结果外科是发生医疗纠纷最多的学科,其中骨科发生医疗纠纷的比例最高为18.70%。上海地区医疗纠纷的医方因素主要包括沟通告知不足和技术水平不足,患方因素表现在对医疗行为存在误解和对疾病的预后期望高,疾病因素包括疾病类别以及疾病的治疗效果。结论加强医生临床技能以及沟通技巧的培训,提高医疗服务质量,合理管理患者期望,积极促进医患共同决策,规范医疗营销行为,以此减少医疗纠纷的发生。Objective To analyze the causes of medical disputes by analyzing the medical disputes in eight hospitals in Shanghai in the past three years, and put forward targeted suggestions based on the service gap model. Methods A stratified and clustered sampling of 524 cases of medical disputes from eight hospitals in Shanghai was conducted, and questionnaire survey and descriptive statistical methods were used to analyze the distribution of disputes and the causes of medical disputes. Results Surgery was the subject with the most medical disputes, and the highest rate of medical disputes was orthopedics(18.70%). Medical factors of medical disputes in Shanghai mainly include insufficient communication and lack of technical skills. Patient factors were manifested in misunderstanding of medical behaviors and high prognosis expectations of diseases. Disease factors included disease types and treatment effects. Conclusion It is essential to strengthen the training of doctors’ clinical skills and communication skills, improve the quality of medical services, manage patient expectations reasonably, actively promote joint decision-making between doctors and patients, and standardize medical marketing behaviors to reduce the occurrence of medical disputes.

关 键 词：医疗纠纷 医方因素 患方因素 疾病因素 

分 类 号：R197.32[医药卫生—卫生事业管理]