上海某三甲医院推行医师执业责任保险实证研究

Implementation of medical practitioner liability insurance in a Shanghai tertiary hospital:An empirical study

目的通过实证研究,了解上海某三甲医院临床医师参加医师执业责任保险的情况和影响参保的因素,为我国推广医师执业责任保险提供政策建议。方法以上海某三甲医院医师为调查对象(2019年度400名,2020年度455名),在全院范围内推行医师执业责任保险,通过评价2019年度和2020年度医师执业责任保险各条目的参保率和满意率,分析医师执业责任保险的参保效果和影响因素。结果医师执业责任保险参保率由2019年度的49.50%增加到2020年度的69.70%,增长幅度达20.5%;不同临床医师工作年限、职称和科室间比较,医师执业责任保险参保率差异有统计学意义(P<0.05);近3年经历过医疗纠纷的临床医师其参保率高于未经历过的临床医师,差异有统计学意义(P<0.05)。结论试点的三甲医院医师执业责任保险参保率较高,科室、工作年限、职称、是否经历过医疗纠纷是医师购买执业责任保险的影响因素;医师执业责任保险体系需完善,相关部门应在现有制度范畴下,简化保险公司理赔程序、提高承保范围;要加强宣传力度,从根本上强化临床医师的医疗执业保险意识,提高医师执业责任保险参保率。

Objective To investigate physicians’insuring the medical practitioner liability insurance and the influencing factors through the empirical study so as to give suggestions to the hospitals in terms of promoting the medical practitioner liability insurance across China.Methods Medical practitioner liability insurance was promoted in a Shanghai tertiary hospital and physicians(400 in 2019,455 in 2020)in that hospital were studied.The effects of the insurance and the influencing factors were analyzed through evaluating the insurance rate of the liability insurance and the satisfaction between 2019 and 2020.Results In 2020,the rate of buying medical practitioner liability insurance increased from 49.50%in 2019 to 69.70%in 2020,up 20.5%.The rate of buying medical practitioner liability insurance with different working years,professional titles and departments showed statistically significant differences(P<0.05).The rate of buying medical practitioner liability insurance of physicians once involved in medical disputes in recent 3 years was higher than that of physicians yet to be involved in medical disputes(P<0.05).Conclusion The rate of buying medical practitioner liability insurance in the pilot tertiary hospital is relatively high.Departments,working years,professional title and experience of medical disputes are influencing factors.Under the existing system,relevant departments should improve the medical liability insurance mechanism by simplifying insurance process and enhancing the insurance coverage,and improve publicity and the awareness of the physicians in terms of medical practitioner liability insurance,thus increase the rate of medical practitioner liability insurance.