Researches On The Core Indexes On Medical Malpractice

ObjectiveImprove the standardization process of forensic appraisal for medical tangle in our country; illustrate the major theoretical bases, the appraisal methods, and the assessment system of expert opinions of the medical tangle; analyze parties’views on the malpractice of an expert opinion; assess the risk of forensic appraisal for medical tangle; thus confirm the core index of a medical malpractice, based on which the quantized standards and rules can be established.MethodsSampling500cases at random from692medical tangle cases happened from2006to2011of one forensic science institution. Dividing them into several parts by different medical services. Analyzing the500cases by using these methods:1.document analysis:the analysis of nearly100theses on medical tangle and the appraisal of medical tangle initiated us into the incidence rate and solution at home and abroad in recent years. Thus know the basic analysis methods of medical tangle cases.2. systematic sampling for small samples:based on the percentage of cases of every medical service in the500cases, picking30cases by systematic sampling, and calculating the correlations of basic information, appraisal process, medical malpractice, damage consequence, and the causal relationship relevance between the medical malpractice and the damage consequence.3. undetermined model:reviewing documents, analyze small samples and studying related laws and regulations, and then setting an initial appraisal methods, medical malpractice, damage consequence, and the causal relationship relevance between the medical malpractice and the damage consequence as core indexes on medical malpractice judgement.4. preliminary experiments:sampling60cases at random from the500cases and doing statistical analysis according to the core indexes mentioned.5.investigations by experts:asking clinical experts and forensic experts to make investigations on the results of preliminary experiments6.analysis of samples:analyze the500cases according to the core indexes mentioned. Using Office2010to format the resulted data.7.data processing:doing statistical analysis and tests to the formatted data by SPSS18.0.ResultsIt has a mild increasing trend of the medical tangle appraisal cases from year2008to2011, which is less than the cases in year2006and2007; the number of cases happened in tertiary hospital is much more than the number in second class hospital and other smaller hospitals; It is in the obstetrics, general surgery, orthopedics and other related surgical departments that the medical tangle happened more frequent; As for the index of appraisal methods, the step-by-step model and direct model are widely used in most of the medical tangle cases, and takes up80%; As for the index of medical malpractice, the lack of attention to patient’s condition, the defect of notification and the misoperation in the operation are the most happened malpractices; It has obvious differences on the affirmation of medical malpractice between medical tangle appraisal and medical accident appraisal(P<0.001); It has obvious differences on medical malpractice between parties’ opinions and experts’ opinions(P<0.001);Although the distribution of medical malpractice in hospital of every classes(P=0.473), there exists obvious differences on medical malpractice among different medical departments(P<0.001). As for the index of damage consequence, the autopsy rate for medical tangle is25%, which is lower than the rate calculated abroad. The coincidence rate of forensic appraisal COD and the clinical diagnose COD is33.3%; As for the index of the causal relationship relevance between medical malpractice and damage consequence, the causal relationship relevance is mainly below the D-class. For the same situation of medical malpractice, the relevance has obvious differences in different damage consequence, different class of hospital and different therapy environment. ConclusionThe smooth solution of medical tangle should rely on the judgment of medical malpractice, which needs a better judgment index. A complete system should be built on medical malpractice appraisal method index, medical malpractice index, damage consequence index, the causal relationship relevance index between medical malpractice and damage consequence. Thus it can combine the assessment of traditional medical services with the medical damage obligation in the Tort Law of China. It’s no doubt that by regulating the medical tangle appraisals, directing the medical tangle appraisal activities and clinical diagnose activities, the physician-patient relationship nowadays will be released in some degree.