基于德尔菲法的医疗过错标准化评估体系构建研究  

Research on the Construction of Standardized Evaluation System for Medical Faults Based on Delphi Method

作　　者：王晓刚 冉隆耀 刘长英 王永生 陈涛[1] 何睿[1] 夏蜀智 刘莉 谢雪[1,5] Wang Xiaogang;Ran Longyao;Liu Changying;Xie Xue(The Second People’s Hospital of Chengdu City,Chengdu,Sichuan,610017,China;不详)

机构地区：[1]成都市第二人民医院,四川成都610017 [2]四川大学华西医院,四川成都610041 [3]中国人民解放军西部战区总医院,四川成都610083 [4]泰和泰律师事务所,四川成都610213 [5]成都市第四人民医院,四川成都610036

出　　处：《中国医院管理》2024年第10期81-86,共6页Chinese Hospital Management

基　　金：四川医事卫生法治研究中心-中国卫生法学会联合项目(YF22-Q15)。

摘　　要：目的构建医疗过错标准化评估体系,为医疗机构及相关领域评估医疗行为的违法性提供参考。方法在文献回顾的基础上,初步构建医疗过错评估体系。采用德尔菲法邀请31名专家对医疗过错评估体系各条目的重要性、可行性作出评价,并提出修改建议。结果两轮专家函询有效回收率分别为83.9%、96.8%,专家权威系数分别为0.902、0.887,各级条目Kendall’s W检验差异均有统计学意义(P<0.001)。最终构建的医疗过错评估体系包括依法执业、知情告知、诊疗技术、病历文书、医院管理5个一级条目和10个二级条目、20个三级条目、47个四级条目,各条目重要性和可行性评分均值均大于4、标准差均小于1、变异系数均小于0.2。结论医疗过错标准化评估体系科学可靠,具有一定的创新性和适用性。Objective Establish a standardized evaluation system for medical faults,and provide theoretical basis for medical institutions and related industries to evaluate the illegality of medical behaviors. Methods Based on a literature review,the medical fault assessment system was initially constructed,and then a research group was established to use Delphi method to invite 31 experts to evaluate the importance and feasibility of each article of the medical fault assessment system and put forward suggestions for modification. Results The effective recovery rates of the two rounds of expert consultation were 83.9% and 96.8%,the expert authority coefficient was 0.902 and 0.887,and the Kendall's W test of all levels differences were statistically significant(P<0.001). The medical fault assessment system finally constructed includes 5 first-level items including practicing medicine according to law,informed notification,diagnosis and treatment technology,medical record documents and hospital management,as well as 10 second-level items,20 third-level items and 47 fourth-level items. The mean values of importance and feasibility scores of all articles were greater than 4,standard deviations were less than 1,and coefficients of variation were less than 0.2. Conclusion The medical fault standardized evaluation system is scientific,reliable,innovative and applicable.

关 键 词：医疗过错 标准化 评估体系 德尔菲法 

分 类 号：R197.323.4[医药卫生—卫生事业管理]