基于定性比较分析的医疗事故鉴定医方责任影响因素研究  

Research on Influencing Factors of Medical Liability in Medical Accidents Appraisal Based on Qualitative Comparative Analysis

作　　者：罗怡 张磊 王文华 袁潇潇 王雪 吴勋仓 Luo Yi;Zhang Lei;Wang Wenhua(Shaanxi Provincial Health Industry Association Service Center,Xi’an,Shaanxi,710003,China;不详)

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

出　　处：《中国医院管理》2024年第3期72-75,共4页Chinese Hospital Management

基　　金：陕西省科学技术厅2022年一般项目-社会发展领域(S2022-YF-YBSF-1458)。

摘　　要：目的探索医疗事故鉴定结论为医方责任的关键因素及组合作用路径类型,为减少医疗事故、构建和谐医患关系提供解决对策。方法运用定性比较分析方法,对某省2015—2019年125例医疗事故再次鉴定案例进行分析,使用fsQCA软件开展必要性分析和组态路径研究。结果导致医疗事故医方责任的组态有3种,总体一致性为0.853659,覆盖率为0.603448;得出医方责任结论产生的3条路径,并概括出医疗机构管理缺位型、医务人员技术过失型、医患双方综合作用型3种组合作用类型。结论重视医疗机构制度流程管理是规避医方责任的基础,规范医务人员诊疗行为是减少医疗事故的核心,强化人文观念及医患沟通是预防医疗事故的关键。Objective Explore the key factors and the type of combined role path of medical accident appraisal conclusion for the medical responsibility,and provide solution countermeasures for the reduction of medical accidents and the construction of a harmonious doctor-patient relationship.Methods Qualitative comparative analysis(QCA)was used to study 125 cases of medical accident appraisal center in a certain province from 2015 to 2019.The fs QCA software was used to detect the necessity of single factor and the configuration path of multiple factors.Results There were three solutions to the configuration of medical liability for medical accidents,with an solution consistency of 0.853659 and an overall coverage rate of 0.603448;draw three paths for the conclusion of medical liability,and summarize three types of combined effects:medical institution management vacancy type,medical staff technical negligence type,and comprehensive effect type of both doctors and patients.Conclusion Attaching importance to institutional management is the basis for evading medical liabilities,standardizing medical staff's diagnosis and treatment behavior is the core to reduce medical accidents,and strengthening humanistic concepts and doctor-patient communication are the key to prevent medical accidents.

关 键 词：医疗事故鉴定 医方责任 影响因素 定性比较分析 

分 类 号：R951[医药卫生—药学]