中国医学伦理学2025，Vol.38Issue(1)：131-138,8.DOI:10.12026/j.issn.1001-8565.2025.01.19
医疗纠纷发生原因分析及对策研究
Analysis of the causes of medical disputes and research on countermeasures:based on the practice of handling medical disputes in a certain hospital from 2018 to 2023
摘要
Abstract
Objective:To explore the current situation,causes,and countermeasures of medical disputes in a tertiary A comprehensive hospital in Xi'an from 2018 to 2023.Methods:A total of 804 medical dispute cases that had been processed in a tertiary A hospital in Xi'an from January 2018 to December 2023 were collected.The occurrence,current characteristics,and cause distribution of medical disputes were retrospectively analyzed.Results:The cumulative incidence rate of medical disputes was 4.408/100,000,and the compensation rate was 31.59%(254/804).The incidence and compensation rate of medical disputes showed an overall increasing trend year by year from 2018 to 2023(P<0.05).The proportion of deceased patients in dispute cases in the past 6 years showed an increasing trend annually(χ2=30.396,P=0.011).Medical dispute cases mainly came from hospitalized patients(65.17%)and patients undergoing surgical treatment(55.35%),and the top five departments with medical dispute cases were the hepatobiliary surgery department,cardiovascular medicine department,obstetrics and gynecology department,emergency department,and gastroenterology department.The number of in-hospital mediations showed a decreasing trend annually,while the number of people's mediations showed an increasing trend annually from 2018 to 2023(χ2=34.523,P<0.001).The top five causes of medical disputes in this hospital were surgical/operational complications(29.10%),disease condition assessment/disease diagnosis(10.45%),diagnosis and treatment plan(9.45%),diagnosis and treatment effectiveness(8.83%),and medical insurance reimbursement(7.59%).Conclusion:The number of medical disputes and compensation cases in comprehensive hospitals is increasing annually,and high-risk departments such as the surgical department and emergency department need to be given high attention.The handling of medical disputes has shown diversification,with people's mediation gradually taking the dominant position.The causes of medical disputes mainly concentrated on diagnosis and treatment technology,doctor-patient communication,medical insurance,and other aspects.It is necessary to continuously improve the level of clinical diagnosis and treatment technology,strengthen doctor-patient communication,improve the medical insurance system,strengthen hospital connotation management,alleviate doctor-patient conflicts,and builds a harmonious doctor-patient relationship.关键词
医疗纠纷/医患关系/综合医院/医患沟通Key words
medical dispute/doctor-patient relationship/comprehensive hospital/doctor-patient communication引用本文复制引用
闫晓婷,樊毅,佘苗..医疗纠纷发生原因分析及对策研究[J].中国医学伦理学,2025,38(1):131-138,8.基金项目
陕西省创新能力支撑计划"DRGs支付方式改革对公立医院医疗服务行为影响的研究"(2022KRM194) （2022KRM194）
西安交通大学第一附属医院科研发展基金"基于DRGs病组下全诊疗过程知情同意体系的建设"(2022RKX-10) （2022RKX-10）
