背景:医疗损害责任纠纷(CMDLD)的赔偿严重阻碍了医院的健康发展,破坏了医患关系的和谐。DPR中的风险管理已成为当今的紧迫问题。本研究旨在对我国CMDLD进行全面描述,并探讨其影响因素,并对DPR中的风险管理提出相应的建议。
方法:本研究的数据来自中国判决在线-官方司法搜索网站,覆盖最全面。2015年至2021年1,790起医疗损害责任纠纷案件(COMDLD)的统计分析
结果:COMDLD总体上呈逐年上升趋势,且各地区分布不均;补偿率为52.46%,薪酬中位数为13.49万元,最高为2234666元;单因素分析结果显示,不同年度的薪酬差异有统计学意义,regions,治疗属性,与试验程序呈显著负相关(R=-0.082,P<0.05);医院类型与地区呈显著负相关(R=-0.082,P<0.05);试验程序与年份呈显著负相关(R=-0.484,P<0.001);代偿与年份呈显著正相关,regions,和治疗属性(R=0.098-0.294,P<0.001),与试验程序呈负相关(R=-0.090,P<0.01);回归分析显示,治疗属性,和地区是影响CMDLD的主要因素(P<0.05)。
结论:年,regions,治疗属性,和试验程序影响CMDLD的结果。本文依据实证成果进一步对医患风险治理提出了相干建议和对策。包括合理配置医疗资源,缩小地区间差异;推动优质资源扩容下沉,提高各级医院医疗服务水平;发展医疗纠纷第三方协商机制,降低医疗诉讼成本等。
BACKGROUND: Compensation for medical damage liability disputes (CMDLD) seriously hinders the healthy development of hospitals and undermines the harmony of the doctor-patient relationships (DPR). Risk management in the DPR has become an urgent issue of the day. The study aims to provide a comprehensive description of CMDLD in China and explore its influencing factors, and make corresponding recommendations for the management of risks in the DPR.
METHODS: This study extracted data from the China Judgment Online - the official judicial search website with the most comprehensive coverage. Statistical analysis of 1,790 litigation cases of medical damage liability disputes (COMDLD) available from 2015 to 2021.
RESULTS: COMDLD generally tended to increase with the year and was unevenly distributed by regions; the compensation rate was 52.46%, the median compensation was 134,900 yuan and the maximum was 2,234,666 yuan; the results of the single factor analysis showed that there were statistically significant differences between the compensation for different years, regions, treatment attributes, and trial procedures (P < 0.05); the correlation analysis showed that types of hospitals were significantly negatively associated with regions (R=-0.082, P < 0.05); trial procedures were significantly negatively correlated with years (R=-0.484, P < 0.001); compensat- ion was significantly positively correlated with years, regions, and treatment attributes (R = 0.098-0.294, P < 0.001) and negatively correlated with trial procedures (R=-0.090, P < 0.01); regression analysis showed that years, treatment attributes, and regions were the main factors affecting the CMDLD (P < 0.05).
CONCLUSIONS: Years, regions, treatment attributes, and trial procedures affect the outcome of CMDLD. This paper further puts forward relevant suggestions and countermeasures for the governance of doctor-patient risks based on the empirical results. Including rational allocation of medical resources to narrow the differences between regions; promoting the expansion and sinking of high-quality resources to improve the level of medical services in hospitals at all levels; and developing a third-party negotiation mechanism for medical disputes to reduce the cost of medical litigation.