Medical Dispute Influence Factors Analysis And Medical Risk Sharing Strategy Research Of Sichuan Province

[Objective]This research via the present situation、causes、handling and result of medical disputes happened in Sichuan province, analyze the existent issue and its influencing factors; By understanding the attitude and position of the various stakeholders about medical liability insurance in Sichuan province, analysis the situation and influencing factors of medical liability insurance in Sichuan province. On this basis, the comprehensive utilization of science of law、insurance、economics and the other related theory, put forward the medical risk sharing mechanism, so as to protect the interests of both doctors and patients, promote social harmony and stability.[Method]The following five methods are mainly used:(1) Literature analysis method:About the doctor-patient relationship and medical disputes, medical risk, risk sharing, medical liability insurance in the literature and the national, provincial relevant policy documents, a typical model for the analysis of domestic and foreign medical liability insurance, formulation of questionnaire and interview outline, provided a reference for subsequent data analysis.(2) Expert consultation method:This study through four rounds of experts to discuss, to evaluation index design, field survey questionnaire> interview outline etc.(3) Questionnaire survey method:The basis of the investigation level 2 and above hospital information, information on handling medical disputes, the dispute occurrence characteristics, and so on.(4) Interview method:Understand the various stakeholders cognition, attitude of medical liability insurance, and the legal framework to promote the effective implementation of strategies and Suggestions; Understand the patients’ cognition of medical dispute、attitude and purchase intention of medical accident insurance.(5)Statistical analysis method:On the basis of investigation data on site using spss19.0 statistical software statistical description and inference; Using multiple regression analysis method to analyze the influence factors of medical disputes, the influence factors of medical liability insurance to buy intention, the influence factors of medical accident insurance purchase intentions.[Result](1) different economic level area:according to the diagnosis and treatment times for calculation of the occurrence probability of medical disputes, the second region the highest incidence of medical disputes,15.3/10; Calculated on the number of doctors medical disputes probability, the probability of three kinds of medical disputes occurred in the highest,9.3%. Different hospital level:according to the diagnosis and treatment times for calculation of the occurrence probability of medical disputes, tertiary hospital medical disputes probability is lower than the secondary hospital; Calculated on the number of doctors medical disputes probability, tertiary hospital medical disputes probability is higher than the secondary hospital.(2)The basic characteristics of medical disputes and law:Patients in medical disputes is given priority to with junior high school education, the majority of rural residents, the share of medical costs way is given priority to with payment. Doctors and nurses are the main medical dispute, the doctor bachelor degree or above, intermediate title is given priority to, the nurse is given priority to college degree. Medical risk high-risk departments for surgery, surgical orthopaedic most; Followed by the gynecology and obstetrics, internal medicine, pediatrics, surgery, emergency, regions.(3) The trend of dealing with the medical disputes are these:the prescriptions of medical disputes comprehensive judgment result shows that about 64% of prescriptions have the responsibility; For patients with the main demand of medical disputes is giving economic compensation; The principal way of medical dispute resolution is give priority to in order to negotiate, and hospital managers preferred solution to medical disputes; Medical disputes involve large sums of money for compensation.(4) The influence factors of medical disputes analysis results:Hospital Angle, hospital of actual data, sickbed utilization rate, bed than average such confinement, physicians, total assets, average daily for bed day have an impact on medical disputes; Medical staff level, the doctor’s age, title, become a fixed number of year has influence to the medical disputes, the nurse education have an impact on the effect of medical disputes; patients with Angle,Patient’s age, educational background and region economic level have an impact on medical disputes.(5) Medical risk sharing strategy attitude survey results:Hospital surveyed medical liability insurance rate is not high, ginseng protect enthusiasm is not high also, High awareness of medical staff of medical liability insurance, purchase intention is higher, medical staffs age and title affect the purchase intention of medical liability insurance; Patients of medical accident insurance awareness is not high, purchase intention is not high, the patient’s degree affect the purchase intention of medical accident insurance.[Conclusion](1) There exist the following problems handling medical disputes in our province and put forward Suggestions to solve these problems:Medical dispute resolution mechanism is not perfect in our province, it is recommended that the establishment of an independent and impartial third party mediation mechanism; Both doctors in the understanding of the doctor-patient relationship is different, the prescriptions that the doctor-patient relationship nervous, think the doctor-patient relationship, suggest that in the process of dealing with medical disputes in our province should protect medical staff, especially their psychological problems; Medical dispute treatment in our province and compensation mechanism is imperfect and advice in the form of law to establish the standard medical dispute resolution procedures, formulate unified medical risk compensation mechanism.(2) According to the influence factors of medical disputes in our province medical risk allocation strategy:From the perspective of the prescriptions of medical liability insurance share the strategy. Priority to the development of commercial medical liability insurance, and enforcement; Medical liability product diversification, to meet different needs; To formulate reasonable compensation limit to prevent insurance institutions exit insurance market; Combine hospital scale and service function calculates the premium; Premium taken by hospitals and medical personnel according to certain proportion share; Determine its insurance time limit, traces the prescription period and claim medical risk should be considered when long incubation period, exist for a long period; Policy-holder and insurant are various medical institutions at all levels, but the medical staff to carry out practice must participate in their own medical institutions of medical liability insurance; Considering economic strength, internal talent structure, choice of claim limitation factors such as insurance institutions. Clarify the legal status of medical liability insurance. From the perspective of risk of side of medical accident insurance share the strategy. As many of the insurance liability of medical liability insurance for not including medical accident, so medical accident insurance shall be in the form of supplementary medical liability insurance implementation; Medical accident insurance fund-raising party is medical institutions.