新西兰医疗风险防范及监管机制现状的循证评价——完善诉讼体系,规范医疗行为,防范医疗风险

Evidence-Based Evaluation of a Medical Risk Management System and Preventative Measures in New Zealand

目的循证评价新西兰医疗风险监测预警机制的现状与防范措施,为我国医疗风险监测预警机制的建立提供参考。方法计算机检索EI(1969～2006)、SCI和SSCI(1975～2006)、EMBASE (1966～2006)、SCOPUS(100％包含MEDLINE)(1960～2006),VIP (1989～2006)、CNKI(1979-2006)数据库和官方及医疗相关网站,如WHO、新西兰卫生部、新西兰医疗协会和新西兰健康与残疾委员会等。收集有关新西兰医疗风险防范和监管方面的相关文献,筛选和评价文献质量,进行描述性研究。结果共纳入文献10篇,主要涉及医疗不安全事件、病人安全和医疗诉讼保险等内容。新西兰在防范医疗风险过程中采取了多层次的防范和处理措施,通过加强医疗操作规范、医患交流、安全意识及促进医院信息化建设等措施防范医疗差错、提高医疗质量。同时,通过修订卫生从业人员资格认证法案和进一步改革完善医疗诉讼体系等,构建了与其相适宜的法律环境,从各个层面上防范和监管医疗风险。结论新西兰建立了较为完善的医疗风险监管体系,特别是其医疗诉讼体系和相关法律,值得我们借鉴和学习。

Objective To provide information for the establishment of a medical risk monitoring and precaution system in China, by reviewing and analyzing the current status of medical risk management system and preventative measures in New Zealand,Methods We searched E1 （1969-2006）, SC1 and SSC1 （1975-2006）, EMBASE （1966-2006）, SCOPUS （included 100% MEDLINE） （1960-2006）, VIP （1989-2006）, CNKI （1979-2006） and relevant official and governmental websites. This search was conducted in January 2006 and articles about medical risk management and prevention were collected. Results We included 10 articles involving medical adverse events, patient safety and medical litigation. New Zealand took many measures in order to prevent medical error and improve medical quality, including strengthening medical practice standards, doctor- patient communication, safety awareness and promoting informationization of hospitals. New Zealand also revised ＂The Health Practitioners Competence Assurance Act＂ and improved medical litigation to form an appropriate law environment. Conclusions New Zealand has taken many measures and established a medical risk management system to prevent medical risk. Some issues of particular relevance to China include building corresponding medical litigation and relevant laws and regulations..