某医院医疗纠纷成因216例分析及防范措施

目的分析某医院医疗纠纷成因并提出防范措施。方法对该院医疗纠纷发生主要原因按违反规章制度和操作规程、观察病情不细致、处理不及时、漏诊误诊、医疗器械质量不过关、医师技术责任造成事故、患方医学知识缺乏、费用纠纷及医师多点执业等几方面分类整理并录入电脑,采用Excel2007进行分析,对医疗纠纷年间分布、患者情况、当事医师情况等内容等进行描述分析。结果本组医疗纠纷发生主要原因为违反规章制度和操作规程,观察病情不细致、处理不及时,漏诊误诊,医疗器械质量不过关,医师技术责任造成事故,患方医学知识缺乏,费用纠纷,所占比例分别为25.00%、20.83%、9.72%、11.11%、6.94%、18.06%、8.33%;本组医疗纠纷特点随着时间呈上升趋势,2010年为39.35%,患者高龄发生率为31.02%、急诊抢救阶段多发(35.65%),当事医师学历低,大专及以下发生率为45.37%,医师多点执业发生率为7.87%。结论造成医疗纠纷的原因很多,有医方因素,有患方因素,也有社会因素。防范重点在于,加强医疗管理,提高医疗质量,改善就诊环境,方便病人就诊,强化法律意识,树立法制观念,对医师多点执业完善相关法律法规。

Analysis of 216 cases of medical malpractice causes and its preventive measures in a hospital

OBJECTIVE To analyze the causes of medical malpractice in a hospital and propose preventive measures.METHODS The main reasons for medical disputes occurred in our hospital were violation of rules and procedures,not careful observation and not handled timely,misdiagnosis,inquality of medical device,physician technical responsibility for the accident,lack of medical knowledge and the cost as well as multi-sited licensed.The data were entered into computer by Excel 2007.The distribution of years of medical malpractice,the patient’s condition,doctors and so the parties were described and analyzed.RESULTS The main reasons for medical dispute were the violation of regulations and operating procedures,not careful observation of the disease,treatment not timely,misdiagnosis,medical device quality tests,physician technical responsibility for the accident,lack of knowledge of medicine,the cost disputes and the proportion were 25.00%,20.83%,9.72%,11.11%,6.94%,18.06% and 8.33%,respectively.The medical malpractice in this group was characterized by an upward trend over time.39.35% were occurred in 2010,31.02% showed senior citizens,35.65% showed emergency rescue phase multiple,45.37% showed physicians showed low qualifications and low education level with college or below,7.87% showed multi-sited licensed.CONCLUSION There were many reasons for medical disputes,the medical side,the risk of side factors and social factors.We should focus on prevention,strengthen health care management,improve quality of health care,and improve the environment for patient’s treatment,strengthen legal awareness and establish a legal concept.