98例医疗过错鉴定的回顾性分析

Retrospective study on 98 cases of medical treatment faults

目的 探讨医疗过错案件共性与特点。方法 对同济医学院法医学鉴定中心2011年1月至2013年12月98例患者死亡的医疗过错鉴定案例进行回顾性分析。结果 98例医疗过错鉴定案件中,死因以重症冠心病最多;男性比例稍高于女性,年龄分布高峰在30~60岁,婴儿期为另一个小高峰;医院等级以三级最多;科室分布以儿科最多;经司法鉴定后,一级医院的过错集中在诊断环节和未尽注意义务,二、三级医院的过错集中在治疗环节。结论 为减少医疗纠纷并提高医疗质量,应注重一级、二级医院基础设施建设,加强医护人员的培训。三级医院应进一步完善知情同意、病历书写等细节。诊疗过程中及时与患者及家属沟通,完善患者投诉处理制度。

Objective To explore the common features of medical dispute cases. Methods 98 cases from January 2011 to December 2013 were reviewed. Results In the 98 cases, most of cause of death is severe coronary heart disease. Male morbidity is slightly higher than female. The incidence between the thirties and sixties was the highest, following by infancy period. The third grade hospitals accounted for the largest proportion of medical disputes. The distribution was firstly in pediatric department. After forensic identification, the faults of first-grade hospitals entirely focused on diagnostic aspects and duty of care, the faults of secondary and tertiary hospitals focused on the aspects of treatment. Conclusion To reduce medical disputes and improve quality of care, we should pay attention to strengthen the primary and secondary hospitals infrastructure and the training of medical staff. Tertiary hospitals should further improve the informed consent, medical records and other details. Medical staff should communicate with patients and their families timely during the process of treatment. The hospital should establish and perfect the system regarding the complaints handling.