某省医疗事故省市两级鉴定结论分析

Analysis of the technic appraisal conclusion of two class area medical associations to the medical accidents

目的：了解某省省市两级医学会医疗事故技术鉴定的状况。方法：对某省医学会2003年1月1日到2003年12月31日期间医疗事故再次鉴定的案例进行统计、比较分析。结果：某省省市两级医学会医疗事故技术鉴定结论一致率仅为48．15％，省市两级鉴定结论差异有统计学意义（Kappa=0．22，95％可信区间为0．11-0．33，P〈0．05）；再次鉴定结论患方有利率为38．16％，医方为67.74％，医患双方结论有利率差异有统计学意义（P〈0．05），但不同申请方委托途径构成及医疗机构级别构成差异均无统计学意义（P〉0．05）；结论：省市两级医学会鉴定结论一致性较低；申请再次鉴定时，患方再次鉴定结论有利率低于医方；再次鉴定委托途径及医疗机构级别不影响鉴定结论的公平性。

Aim ： To understand the status of the technic： appraisal of two class medical associations to the medical accidents. Methods： The medical accidents that were appraised for the second time in Henan province from Jan. 1 , 2003 to Dec. 31, 2003 were analyzed. Results： The consistence rate of appraisal conclusinns from eiuic and provincial medical association was 48. 15% , and the difference was significant （ Kappa = 0.22, 95% confidence interval： 0. 11 - 0.33, P 〈 0.05 ）. The beneficial rate of the second technic appraisal for the patients was 38, 16% , and that for the medieal organizations was 67.74% , P 〈 0.0.5, however, the proportion of entrusting way of the applicants and the ranks of the medical organizations had no significant difference （ P 〉 0.05）. Conclusion ： In the second technic appraisal, the beneficial rate for the patients is lower than that for the medicine organizations. The entrusting way of the applicants or the ranks of the medical organization in the second technic appraisal do not impair the fairness of the appraisal conclusion.