公立医院医师责任保险运行实践与思考——以上海某三级医院为例  

Practice and thinking on the physician's liability insurance in public hospitals:Take a tertiary hospital in Shanghai as an example

作　　者：计光跃 JI Guangyue(Tenth People's Hospital of Tongji University,Shanghai 200072,China)

机构地区：[1]同济大学附属第十人民医院,上海200072

出　　处：《卫生软科学》2023年第4期79-82,共4页Soft Science of Health

摘　　要：[目的]分析医师责任保险在三级医院运行的初步情况,为其进一步发展提出建议。[方法]以上海某三级公立医院为例,收集2018-2021年医师责任保险在该院投保、理赔信息并进行描述性统计分析。[结果]该院投保医师人数从2018年的64人增长到2021年279人,已占全院医师总人数的37.91%。其中普通医师、主治医师、主任/副主任医师分别占30.57%、29.60%和52.71%;4年平均每件案件理赔67,949.49元,平均赔付率为105.98%。[结论]医师责任保险对医师的医疗风险转移效果明显,是医疗执业保险的重要发展方向,但医师投保存在一定逆向选择,政府、医疗行业协会、医院等各利益相关方应合力推动其良性、健康发展。Objective To analyze the physician's liability insurance in tertiary hospitals,and to put forward relevant suggestions for its further development.Methods The data of physicians liability insurance and compensation information of a tertiary hospital in Shanghai from 2018 to 2021 was collected and descriptive statistical analysis was used.Results The number of insured physicians increased from 64 in 2018 to 279 in 2021,accounting for 37.91%of the total number of physicians in the hospital.General practitioner,attending physician and chief/associate chief physician accounted for 30.57%,29.60%,and 52.71%respectively.The average compensation for each case in four years was 67,949.49 yuan,and the average compensation rate was 105.98%.Conclusions Physician's liability insurance has an obvious effect on the transfer of medical risks for physicians,and it is an important development direction of medical practice insurance.However,there is a certain adverse selection in physician insurance.Stakeholders such as governments,medical associations and hospitals should work together to promote its sound and healthy development.

关 键 词：医师责任保险 投保 三级公立医院 上海 

分 类 号：R197.3[医药卫生—卫生事业管理] R192.3[医药卫生—公共卫生与预防医学] F840.6[经济管理—保险]