防御性医疗检查与医疗纠纷关系

Relationship between precautionary medical examination and medical disputes

目的了解防御性医疗检查与医疗纠纷的成因及相互关系,为制定政策、减少防御性医疗检查,缓解医患关系提供参考依据。方法于2018年1—3月,通过方便抽样选取广州市的7家医院,通过互联网平台和发放纸质问卷的方式,对324名内科、普通外科、妇科患者进行问卷调查;采用Excel与SPSS 20.0对调查资料进行统计学分析。结果不同年龄和学历患者经历防御性医疗检查比例差异有统计学意义(P均<0.001),硕士及以上学历患者遭遇防御性医疗检查的比例为66.7%,远超大专及以下和本科学历患者(分别为22.7%和24.9%);不同年龄和学历患者经历医疗纠纷比例差异有统计学意义(P均<0.001);是否遭遇过医疗纠纷会影响患者是否怀疑医生进行防御性医疗检查(P<0.05);而经历过防御性医疗检查的患者比未经历的患者更容易遭遇医疗纠纷(P<0.001)。结论防御性医疗检查与医疗纠纷关系密切,为控制防御性医疗检查,国家应制定政策保护医生,普及医学常识;医生应遵循道德规范,提高职业技能。

Objective To examine the cause of precautionary medical examination(PME)in favor of doctors′willingness and medical disputes and the relationship between them and to provide references for developing strategies to reduce unnecessary PME and to improve doctor-patient relationship.Methods We conducted an on-site and internet-based questionnaire survey among 324 patients selected with convenience sampling at internal medicine department,general surgery department and department of gynecology of 7 hospitals in Guangzhou city between January and March 2018.Statistical analysis was conducted with Excel and SPSS 20.0.Results There were statistically significant differences in the ratio of experiencing PME among the participants at various ages and with different education background(both P<0.001);the participants with the master′s degree reported higher proportion(66.7%)of experiencing PME than the participants with university degree(24.9%)and those with college degree or below(22.7%).There were also significant differences in the ratio of experiencing medical dispute among the participants at various ages and with different education background(P<0.001).The participants′experience of medical dispute influenced their suspicions about precautionary medical examination(P<0.05);while the participants experiencing PME were more likely to have medical disputes than those who not experiencing PME.Conclusion Precautionary medical examination is closely related to medical dispute.Relevant policies should be formulated by the government to control the prevalence of precautionary medical examination.