2016—2019年陕西省再次医疗事故技术鉴定案例分析  

Case analysis of technical identification of re-medical accidents in Shaanxi province from 2016 to 2019

作　　者：张磊 刘昌奎 梁斌 罗怡 吴勋仓 王文华 ZHANG Lei;LIU Changkui;LIANG Bin;LUO Yi;WU Xuncang;WANG Wenhua(the Health Industry Association Service Center of Shaanxi Province,Xi'an 710003;Shaanxi Medical Association,Xi'an 710003;School of Stomatology,Xi'an Medical University,Xi'an 710021,China)

机构地区：[1]陕西省卫生行业学会服务中心,陕西西安710003 [2]陕西省医学会,陕西西安710003 [3]西安医学院口腔医学院,陕西西安710021

出　　处：《临床医学研究与实践》2023年第16期171-174,共4页Clinical Research and Practice

基　　金：陕西省科技厅2022年一般项目-社会发展领域(No.S2022-YF-YBSF-1458)。

摘　　要：目的了解2016—2019年陕西省医学会再次医疗事故技术鉴定案例受理情况、鉴定情况和过失原因,为预防、处理医疗事故提供参考依据。方法对2016—2019年陕西省医学会受理的144例再次医疗事故技术鉴定案例的受理情况、鉴定情况、医疗机构及科室分布情况、过失原因进行分析。结果2016—2019年受理的144例再次医疗事故技术鉴定中,鉴定完结案例102例,占70.83%;鉴定完结的102例案例中,经鉴定属于医疗事故案例50例,医疗事故比例为49.02%。经鉴定为医疗事故的50例案例中,一级医疗事故最多,共24例,占48.00%;二级医疗事故最少,共4例,占8.00%;医疗机构负次要责任的最多,共23例,占46.00%;医疗机构负主要责任的最少,共10例,占20.00%。未评级医疗机构的一级医疗事故比例高于三级医疗机构和二级医疗机构,未评级医疗机构主要责任和次要责任比例高于二级医疗机构和三级医疗机构。鉴定完结案例涉及科室排名前5的依次为骨科、普通外科、产科、呼吸内科、急诊科和神经内科。过失出现次数排名前3的是治疗-手术操作、其他和治疗-用药。结论要加强医疗事故高风险科室和高风险环节的医疗质量监管,重视未评级医疗机构医务人员的培训、监督和考核,以提升医疗技术水平和医疗安全意识。Objective To understand the acceptance,identification and causes of negligence of the technical identification cases of medical accidents in Shaanxi Medical Association from 2016 to 2019,so as to provide reference for preventing and dealing with medical accidents.Methods The acceptance,identification,distribution of medical institutions and departments,and causes of negligence of 144 cases of technical identification of re-medical accidents accepted by Shaanxi Medical Association from 2016 to 2019 were analyzed.Results Among the 144 cases of re-medical accident technical identification accepted from 2016 to 2019,102 cases completed identification,accounting for 70.83%;among the 102 completed identification cases,50 cases were identified as medical accidents,and the rate of medical accidents was 49.02%.Among the 50 cases identified as medical accidents,the first-level medical accidents were the most,with a total of 24 cases,accounting for 48.00%;secondary medical accidents were the least,with a total of 4 case,accounting for 8.00%;the medical institutions had the most secondary responsibilities,with a total of 23 cases,accounting for 46.00%;the primary responsibility of medical institutions was the least,with 10 cases,accounting for 20.00%.The proportion of primary medical accidents in unrated medical institutions was higher than that in the tertiary and secondary medical institutions,and the proportion of primary and secondary responsibilities in unrated medical institutions was higher than that in the secondary and tertiary medical institutions.The top 5 departments involved in the completed identification cases were orthopedics department,general surgery department,obstetrics department,respiratory medicine department,emergency department and neurology department.The top 3 negligence were treatment-operation,others and treatment-medication.Conclusion Strengthen the medical quality supervision of high-risk departments and high-risk links of medical accidents,attach importance to the training,supervision and asse

关 键 词：医疗事故 鉴定 医疗过失 

分 类 号：R197.3[医药卫生—卫生事业管理]