某战区军队医院医疗风险管理现状及影响因素研究

目的分析军队医院医疗风险发生的规律、特点、高危因素及深层次原因，为制定科学有效的风险管理措施提供依据。方法采用整群抽样、横断面问卷调查的方法，对11所医院496名医护人员的风险意识及相关因素等40项内容进行调查研究．并建立数据库及风险研究模型，所得资料运用SPSS13．0软件进行统计分析。结果三级甲等医院的风险管理体系较三级乙等医院完善；外科、妇产科医疗纠纷高于其他科室，为医疗风险的高危科室；新职工、进修实习及责任心不强的人员为医疗风险的高危人群；Logistic回归分析显示，管理制度、职务、文化程度、风险教育、检查陪同、设备维护和工作量等7项变量与医疗风险密切相关。结论应加强医疗风险、法律法规、服务意识、质量管理教育。建立军队医院风险预警机制和风险管理组织与风险评价体系。

Investigation and Analysis on the Medical Risk Management Situation and Impact Factors of A Military Hospital

Objectives In order to make scientific and effective risk management measures and achieve greater security at lower costs, we investigated regulation, characteristics, risk factors and further reasons of the medical risk present condition in military hospitals. Methods By cluster sampling and cross-section questionnaire methods, we made investigations on 40 contents including risk consciousness and other variables in 496 medical workers from 11 military hospitals,and create the database and risk research model. SPSS 13.0 software was used to analyze the data. Results Compared with three B-level hospitals, three A-level hospitals had better risk managements. Surgery, obstetrics and gynecology medical disputes had high risk of medical dispute. New employees, intern and those were not responsible had higher risk of medical dispute. Logistic regression analysis showed that 7 variables including management system, duty, literacy, risk education, accompanied check, equipment maintenance and workload were related with the medical risks. Conclusions To prevent the medical risks, military hospital should attach importance to educations about medical risks, medical laws, medical service and medical quality management, establish early-warning mechanisms, risk management organizations and scientific evaluation system for medical risks, and effectively promote the scientific, systematic, institutionalized risk management.