乡村私人诊所医疗纠纷处理的影响机制研究  

Analysis of Influencing Mechanism of Medical Dispute Handling in Rural Private Clinics

作　　者：陈钰玲 何浩贤 CHEN Yuling(School of Sociology,Zhejiang University,Hangzhou,Zhejiang,310000,China)

机构地区：[1]浙江大学社会学系,浙江杭州310000

出　　处：《医学与社会》2024年第4期37-42,共6页Medicine and Society

基　　金：国家社会科学基金资助项目,编号为20CZJ023;安徽省高校人文科学重点研究项目,编号为SK2021A0026。

摘　　要：通过探讨乡村私人诊所医疗纠纷处理的影响机制,为乡村医疗卫生服务体系的建设提供经验和参考。运用田野调查方法,获取重大医疗纠纷个案的第一手资料,并提取出纠纷处理的影响因素。研究发现学界已有的解释医疗纠纷处理的维稳机制有其局限性,因为乡村私人诊所处在半熟人社会和竞争性市场的结构中,声誉机制才是诊所处理医疗纠纷时的主要影响机制。基于此,诊所医生发展出间接调解、积极妥协、情感沟通等维护声誉的应对策略,但由于声誉机制具有灵活性、连贯性的特点,纠纷处理的结果往往是多元的、复杂的。声誉机制的作用表明乡村医疗卫生服务的社会基础仍然很重要,对声誉机制的重视有助于完善诊所的管理,促使诊所真正成为基层医疗卫生服务的补充,最终推动乡村医疗卫生服务体系的建设。This paper explores the influencing mechanism of medical dispute handling in rural private clinics,so as to provide experiences and insights for the construction of rural medical and health service system.Through the fieldwork method,first-hand information on major medical dispute cases is gathered,and the factors that impact their resolution are analyzed.It clarifies that the existing explanation of stabilization mechanism falls short because rural private clinics operate within semi-familiar society and competitive markets,and the reputation mechanism is the primary mechanism when clinics deal with medical disputes.Based on this,clinic doctors have developed strategies to maintain their reputation,such as indirectly mediating,positively compromising and affectively communicating.However,with the reputation mechanism being flexible and coherent,dispute outcomes are often multidimensional and complex.The role of the reputation mechanism shows that the social foundation of rural medical and health services remains important.Emphasis on the reputation mechanism can improve clinics management,make them complementary to grassroots health care services and ultimately promote the construction of the rural medical and health service system.

关 键 词：乡村卫生 医疗纠纷 私人诊所 声誉机制 

分 类 号：R-05[医药卫生]