基于扎根理论的医保性医患纠纷影响因素质性研究  

Qualitative study on the influencing factors of medical insurance-related doctor-patient disputes based on grounded theory

作　　者：韩勇彬 燕娟[2] 赵丽娟 HAN Yongbin;YAN Juan;ZHAO Lijuan(Linfen Municipal Health Commission of Shanxi Province,Linfen 041000,China;School of Humanities and Social Sciences,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西省临汾市卫生健康委员会,山西临汾041000 [2]山西医科大学人文社会科学学院,山西太原030001

出　　处：《中国医学伦理学》2024年第10期1195-1201,共7页Chinese Medical Ethics

基　　金：山西省研究生教育创新项目“医保性医患纠纷的成因及对策研究”(2021Y427)。

摘　　要：医疗保障政策进入深度改革并能够有效缓解医患紧张关系,但在实际执行过程中仍会发生医保性医患纠纷。根据扎根理论研究方法,进行半结构式访谈,从而直观、真实地描述医患双方医保性医患纠纷的经历。运用Nvivo11软件对访谈资料进行三级编码,提取诱发医保性医患纠纷的原因。针对医保性医患纠纷的影响因素提取“医务人员、患方群体、医疗环境以及社会环境”4个核心概念并提出缓解医保性医患纠纷的对策:政府加强统筹规划,政策宣传多样化;医院服务精细化,优化医务人员评价体系;提升医务人员职业素养,引导从业规范化;转变患者就医思维,提高政策认知程度。The medical insurance policy has entered into a deep reform and can effectively alleviate the tensions between doctors and patients.However,medical insurance-related doctor-patient disputes still occur during the actual implementation process.Based on the grounded theory research method,semi-structured interviews were conducted to intuitively and realistically describe the experiences of both doctors and patients in medical insurance-related doctor-patient disputes.Nvivo 11 software was used to conduct three-level coding on interview data and extract the reasons that trigger medical insurance-related doctor-patient disputes.in response to the influencing factors of medical insurance-related doctor-patient disputes,four core concepts of“medical staff,patient groups,medical environment,and social environment”were extracted.Additionally,countermeasures to alleviate medical insurance-related doctor-patient disputes were proposed,including the government strengthening overall planning and diversifying policy publicity;hospitals refining services and optimizing the evaluation system for medical staff;improving the professional quality of medical staff and guiding the standardized practice;and transforming patients’medical thinking and improving their policy awareness.

关 键 词：扎根理论 医患纠纷 医疗保险 医患关系 

分 类 号：R-052[医药卫生]