Rational Thought And Research To Health Care Administration And Related Problems In The Medical Trouble Disputes

goal:According to the research to medical trouble disputes appraised by Jilin Medical Association (JLMA) and Changchun Medical Association from 2003-2006, I analyzed the distribution among the hospitals and the main reasons formed the disputes. In order to keep away the medical trouble disputes and develop the hospitals medical practice I also put forward corresponding measures.methods:I investigated the medical opinion materials from 2003 to 2006. I classified the 669 medical trouble disputes cases and analyzed the distribution among the provincial level hospitals, city level hospitals, and county level hospitals and different apartments such as Internal medicine department, surgical department, Gynecology and obstetrics department, Department of pediatrics.I analyzed the hospitals'factors in the medical trouble disputes, which include Medical technology errors, Medical procedure slight defects , Service attitude, Imperfect management, External factors, Technical limit and calculated the rates of the factors and process them with the Statistical methods.I analyzed the Social factors in the medical trouble disputes, which include the improvement of the social legal consciousness, the involvement of medias, welfare system of medical and health care and calculated the rates of the factors and process them with the Statistical methods.I analyzed the Patients'factors which include the lacks of the medical knowledge, dissatisfaction to the treatments, bad motivation, and responsibilities'transformations and calculated the rates of the factors and processed them with the statistical methods. Findings:In the 669 cases the distribution among province level hospitals, city level hospitals, and county level hospitals is 159 cases, 283 cases and 227 cases. In the distribution of departments the first three departments are surgical department, Internal medicine department and Gynecology and obstetrics department. 338 cases happened in Surgical department and it coved 57.2%.116 cases happened in Internal medicine department and it coved i17.3%. 146 cases happened in Gynecology and obstetrics department and it covered 21.8%. There were also a few disputes happed in Department of pediatrics.In the factors that caused the medical trouble disputes, the rate of the disputes caused by the Medical technology errors were much higher than the rates of the disputes caused by other reasons. (P<0.05)There was no obvious difference among the rates of disputes caused by service attitude, imperfect management, and external factors.Conclusion:There are three factors in causes of the medical trouble disputes. They are hospitals'factors, social factors and patients'factors. In the hospitals'factors the rate of disputes caused by the medical technology errors is the highest. In the social factors the rate of disputes caused by the involvement of the Medias is the highest. In the patients'factors the rates of dispute caused by the lacks of the medical knowledge is the highest.By the analysis of the factors which caused the medical trouble disputes.Several aspects of the future work should be pay great attention to.1. Give greater emphasis on competence-oriented education and improve the self-control consciousness. We should enhance the ideological and political education, professional morality education, the education of devotion to their duties and law education to the staffs in the hospitals to enhance their ideas of practicing medicine according to the laws. Good ethics of the profession should be formed and Medical behavior should be regulated in order to keep away and guard against the medical trouble disputes.2. We should improve the hospital management level comprehensively to acclimatize ourselves to the requests of the new laws. More attention should be paid to the medical service quality control, medical record management and hospital rear service management3. Enlarge the propaganda to the medical and health services and understand and process the medical service disputes correctly. On one side we should enlarge the communication with the news Medias and create good social environment for hospitals. On the other side the medical service sanitation system must enlarge the propaganda of the policy, laws and regulations related to the hospitals to enhance the public's understanding to the hygienic profession's particularity and enhance the understanding and the supports by the society members.4. Reconstruct the trust relations between the hospitals and the patients. First, we should emphasis on the transformations between medical patterns and public awareness. Second, we should improve the staffs'awareness of service and quality. Thirdly, we should persevere in the principle that the patients' conditions must be told and the patients'agreements must be asked. Fourth, we should enhance the communications between the staffs and the patients.5. Strict hospital staffs'permit system should be set up. And strengthen the education of doctors'skills to improve the staffs'technical skills.6. Set up and consummate the medical risk security payment system.Under the present situation that the medical risk security system hasn't been set up by the nation and a medical risk insurance organization is needed, which can transform the subjects of the medical disputes'compensation and which is led by the government, noncommercial. The organization is also participated by hospitals doctors and patients and professional health lawyers and executives.The government should take some compulsory insurance patterns and put out the certain proportion of money from the tax to the medical responsibility insurance fund to compensate the gaps between income of the medical institutions and the compensations. Hospitals and doctors should also take some proportion of money to the fund as the guarantee of the risk. In this way the staffs can work initiatively and their medical technology will be improved...