浅析举证责任倒置与诱导性需求

目的:探讨举证倒置实施后,由于诱导性的需求对医疗费用的影响.分析其原因。方法:随机抽取举证倒置政策实施前后住院病例各400份(其中内、外、急诊、骨科各200份),分别计算平均住院费、平均化验费、平均检查费,将费用变化情况进行对比:此外观察诱导性化验及检查在医疗费用增长中所起的作用。结果:举证倒前后平均住院费、化验费、检查费均呈上升趋势,两组间差异有显著性(P<0.001);举证倒置后化验费、检查费在总医疗费用中构成比例由原来的10.5％和8.0％上升到13.8%和9.4％。结论:举证倒置的实施产生了部分医疗方面的诱导性需求,其主要原因是防卫性保护措施。

A preliminary analysis of exchange responsibility of providing evidence and its effects on inducing medical demand

Aim To exploring the consequence of implementing the new law that requiring medical staffs to provide evidence to defend themselves and its impact on inducing more medical demand. Method By randomly selecting 400 hospitalized patients'medical records sespectively before and after the new policy is implemented , calculating the average hospitalization expenditure, average clinical test expenditure and average diagnostic examination expenditure by comparing the changes in those expenditures, to observe the role played by this new policy in inducing more expenditure in medical test and diagnostic examination. Results After the new policy has been implemented that requiring medical staffs to provide evidence of their own innocence, the average hospitalization expenditure, average clinical test expenditure and diagnostic examination expenditure have demonstrated a upturn trend, there is a significant difference between the two groups(PO. 001). After the new policy has been implemented, the percentage of clinical test expenditure and diagnostic examination expenditure has increased from 10.5%, 8%to 13. 8%and 9.4% respectively. Conclusion Evidence provision responsibility being transferred to medical staffs can partly attribute to the medical demand inducement, for medical staffs needs to take more preventive measures to protect themselves.