A Research Of Malpractice Based On Retrospective Methods In China

Malpractice is a worldwide problem. Malpractice is defined as medicalactivities contrary to the expected proper medical care. China’s definition ofmalpractices is which in the clinic activities, medical institutions and medicalpersonnel are at fault and are liable for compensation by the malpractice. In theUnited States, Malpractice litigation make the doctor stand in the dock so oftenand a large number of malpractice lawsuits let the American doctors exhaust.Chinese doctors rarely are faced litigation, but often get into the trouble ofmedical riot threatened by the patients’ family. Some casualties happened in theevent of medical riot.According to the statistics of the non-normal deaths, China’s non-normalnumber of unnatural deaths is more than8million, in which the unnatural deathsfrom malpractice are about400thousand people. The number is about four timesthan the non-normal deaths caused by traffic accidents. In addition, there arelargely number of patients in the process of medical treatment disabled. Printed in1999lately, the American Medical Association published a report that "to error ishuman-building a safer health system." The report pointed out that the occurrence of could be prevented medical errors in hospitals in a year in theunited stateside were about1million, while among the1million malpractice180000patients died from the contrary to the expected health care.Malpractice incident are many reasons. Some are subject to the constraintsof the human level of understanding of medicine and there are many unknownareas in medicines and we have only30percent of the disease knowledge, others70%are unknown area. Therefore, subject to the constraints of the human solvingproblems, malpractice is largely unavoidable. Others due to the medicalpersonnel are not strict with implementation of clinical diagnosis and treatmentpractices. Clinical skills are not enough to be familiar with the treatment ofdisease and the underestimation of risk could lead to some malpractice that youshould avoid in medical practice.Research purposeFor the large number of medical malpractice in the worldwide, foreigncountries have carried out a series of studies, mainly used to improve the qualityof care and reduce the incidence of medical errors. China in this respect has alsomade a certain progresses including the incidence of medical malpractice and thehigh incidence of departments. This study is on the basis of the different aspectsof medical error events and focus on analyzing the causes of medical injury. Atotal of six injuries included patient death, life-long care, disability, severe injury,minor injury and mental injury. And further analysis is the risk factors of theoccurrence of malpractice and the injuries compensation.Based on the medical injuries to patients and their families, but couldn’tget reasonable compensation, the study proposed the establishment of the"mandatory medical liability insurance policies”and proposed that take the courtas an arbitration institution of the malpractice.To achieve a quick settlement of claims through simple procedures for patients, while to strengthen the supervisionof medical institutions. Aim to share compensation risk through the establishmentof the mandatory medical liability insurance and to enable patients to receivereasonable compensation and to let medical institutions far away the predicamentof medical claims.Research MethodsTake into account that they are several solutions of the medical malpracticecompensation. Negotiated with the hospital, the health administrativedepartments coordinate and solve problems, but also resolved through legalproceedings, so it is difficult from one way to collect data. Litigation to deal withthe malpractice compensation is relatively complete, so this research takes themalpractice litigation as study subjection.Judgment of the Court as a cipher text, it is difficult to obtain. So thisresearch used the” Google” search engines and entered search term "MedicalMalpractice Case", that is, a lot of search results, and then opened the page oneby one, saved the Internet-related legal aid website, received a total of595malpractice compensation after the court case, which is equivalent to the censusof network of malpractice cases.The research was a retrospective study. Collected each eligible malpracticecase of injury compensation and extracted important information from every caseand entered the entry of malpractice injury event tables. The information includedthe time, provinces, the extent of injury, the injury compensation of themalpractice incident. It is also divided into death, lifelong dependent care,disability, severe injury minor injury and mental injury based on the extent ofinjury of a total of six injuries. Data is entered to EXCEL spreadsheet entry afterexcluding indicators of incomplete information. Used a double check about dataand analyzed with statistical software SPSS16.0. ResultsChina’s each province, autonomous region and municipality directly underthe central government has malpractice incidence excluded Taiwan province inthis research. The time of malpractice incidence is from the1990to2010. JiangsuProvince, with the highest constituent ratio，was8.57%in all；Beijing, HenanProvince, with the higher constituent ratio，was8.4%， followed by Jiangxi,Shanghai, Shandong Province, Zhejiang Province. Data display a higher ratiohappened in the provinces with more density of population.Institutional type and composition of malpractice incidence revealed: of all595malpractice cases, the provincial level hospital was for82cases, themunicipal level hospital was for211cases, county and district level hospital wasfor188cases, the township level hospital was for62cases, village and city publichealth clinics was for52cases. In different level hospitals, the municipal levelhospital happened malpractice incidence more than other medical institutions.About the malpractice identification analysis pointed out that in a total of595cases272cases applied for Medical Malpractice Identification,123caseswere applications for Expert Testimony,23cases were double applications underMedical Malpractice Identification and Expert Testimony,177cases were judgeddirectly with no malpractice identification. It is worth noting that101cases didn’tbelong to malpractice in the272cases applied for Medical MalpracticeIdentification. However, the court still judged the hospital to assume thecompensation responsibility from the "Tort Law" angle.The malpractice compensation pointed out that the average amount ofcompensation on life-long care was￥453,600; The average amount ofcompensation on disability was￥180,900; The average amount of compensationon severe injury was￥164,900; The average amount of compensation on death was￥140,500; The average amount of compensation on mental injury was￥72,800; The average amount of compensation on minor injury were￥35,400;The compensation on life-long care was highest and the compensation on minorinjury was lowest. Further multiple comparison results that death and disability,death and serious injury, disability and serious injury are no significantdifference.ConclusionTo implement clinical diagnostic and treatment standard strictly will behelpful to prevent some incidents of malpractice. Some medical services can’tenforce the rules and regulations in dealing with diseases. It is very commonphenomenon that the law and chapter couldn’t be executed. Particularly in thesurgical procedure the checking system with double people can’t be carried out sothat surgical gauze residue can’t be found in time in the patient body cavities andthe serious abdominal infection occurred to the patient. This type of malpracticehappened injury to patients for several years or more.Reinforcing communication with patients will help to reduce the occurrenceof malpractice. Partly the malpractice was caused by the with poorcommunication between doctors and patients, such as a surgeon did not informthe clear information what risk the operation will be to the patient beforesurgery；Otherwise the doctor give the absolute expression to the patient aboutthe diagnosis of disease, the patient will bring about resentfulness once themalpractice occurred. So enhancing communication with patients and understandthe patient’s condition better will have an important role to improve the quality ofmedical care.Establishing “Medical Mandatory Liability Insurance” policy and attainingrisk-sharing in china.“Medical Mandatory Liability Insurance” should not be for the purpose of profit and should be subsidized in the government budget andachieve all medical staff participation. Courthouse will be the arbitrationinstitution to realize quick compensation through facility procedure. Themalpractice identification will be organized under double “Medical MalpracticeIdentification” and “Expert Testimony”.“Medical Malpractice Identification”will be assumed the responsibility to strengthen the supervision and managementof medical institutions and Expert Testimony will assume the responsibility toidentify the extent of the malpractice injury.Only in this way, the patient can be attained a reasonable compensation and theoccurrence of medical violence can be avoided effectively.This research is several groundbreaking. The research analyzed the causesand risk factors of malpractice. Named death, life-long care, disability, severeinjury, minor injury and mental injury as six levels of injury result.The researchwill benefit the estimation of funding of compulsory medical liability insuranceand lay a certain foundation to carry out the compulsory medical insurance policyin the future.