某三甲医院2009～2014年医患纠纷影响因素分析

Analysis of influence factors of medical disputes in a tertiary hospital from 2009 to 2014

目的分析医患纠纷的变化趋势及发生的影响因素，为合理解决医患纠纷、促进医患和谐提供参考。方法收集广州市某三甲医院2009～2014年发生的196例医患纠纷，按个案属性、种类进行归纳整理，采用描述性统计、回顾性分析方法对医患纠纷进行分析。结果经属性分析发现，医患纠纷总体呈下降趋势，多集中在内、外科等较复杂科室，占71．43％；初、中级职称人员为医患纠纷的主要责任人，占76．53％；引起医患纠纷的影响因素中以医疗质量问题居首．占43．88％，医患沟通问题、药品器材使用不当、护理质量问题、医务人员法律意识不强及患者自身问题也是引起纠纷的重要影响因素，而协商解决为医院解决纠纷的主要处理方式。结论应加强对医疗核心制度的管理，规范医疗文书的书写，增强医务人员的法律意识，提高医患沟通技巧，减少医患纠纷的发生。

Objective To analyze the variation trend and influence factors of medical disputes, in order to provide refer- ences for solving medical disputes reasonably and promoting a harmonious relationship between doctors and patients. Methods 196 cases of medical disputes occurred in a tertiary hospital of Guangzhou City from 2009 to 2014 were col- lected by the characteristics of individual cases and types. Descriptive statistics and retrospective analysis methods were conducted for analysis. Results Case attributes were analyzed to find that the general trend of medical disputes was decreased, and more concentrated in complex departments such as medicine, surgery, accounting for 71.43%; the mainly responsible for medical disputes were primary titles and intermediate titles, accounting for 76.53%; the quality of medical services was the primary cause, accounting for 43.88%, and communication problems between doctors and patients, improper use of drugs and equipment, nursing quality, weak legal awareness of medical staff and patient prob- lems of its own were other important factors, and the main way to solve the dispute of the hospital was negotiated set- tlement. Conclusion Multiple measures should be taken to decrease the occurrence of medical disputes, include strengthening the management of medical core system, standardization of writing medical files, enhancement of legal awareness of medical personnel, improvement of communication skills.