医疗纠纷中医方过失原因与改进措施研究

Study on the Cause of Medical Errors in Medical Disputes and Improvement Measures

目的:分析675例医疗纠纷案件,提出持续改进医疗质量的对策建议。方法:收集南京市2022年经某医疗责任险经办机构处理结案的675例医疗纠纷案件,分析纠纷案件特点、高发科室、医方过失原因和违反的医疗核心制度,发现医疗机构在诊疗过程中的高风险因素。结果:三级医疗机构年龄大、住院、手术的患者是医疗纠纷高发人群,妇产科、骨科、普外科、急诊科、心胸外科等科室是医疗纠纷的高发科室,手术/操作相关过失是医疗纠纷产生的主要原因,存在会诊制度、病历管理制度等医疗核心制度执行不力的情况。结论:医疗机构应重点关注医疗纠纷发生的高风险因素,针对高风险因素,建立持续加强医疗技术和改进医疗质量与安全的全面质量管理机制。

Objective:To analyze 675 medical malpractice cases and provide countermeasures for continuous improvement of medical quality.Methods:The information of 675 medical malpractice cases handled by a medical liability insurance underwriting agency in Nanjing in 2022 was collected.The characteristics,high-risk departments,medical staff's negligence reasons,and violation of medical core systems in the treatment process were analyzed to identify high-risk factors in the medical institutions'treatment process.Results:The study found that elderly patients,inpatients,and surgical patients in tertiary medical institutions were high-risk groups for medical disputes,and obstetrics and gynecology,orthopedics,general surgery,emergency department,and cardiothoracic surgery were high-risk departments.Operating/procedure-related negligence was the main reason for medical disputes,and there were problems with the implementation of core medical systems such as consultation system and medical record management system.Conclusion:Medical institutions should focus on high-risk factors in medical disputes and establish a comprehensive quality management mechanism for continuous improvement of medical technology and medical quality and safety.