Development Of Medical Dispute Database

Background and objective：Methods:1. QuestionnaireRead the literatures, design the medical disputes questionnaire, hospital medicaldispute cases were retrospectively investigated, statistical analysis of the factors that affectpatient disputes occur.2. InterviewDesign the outline of doctor-patient interviews and interview with hospitalizedpatients. Analyze the medical disputes to identify the risk factors of disputes. And find outthe high risk factors.3. Expert discussionThe expert panel discuss survey results and interviews,and preliminarily design thebasic framework and content of database.4. Delphi method(1) Set up an expert forecasting group.I prepared a preliminary outline of medical disputes questionnaire and thedoctor-patient interviews, patient disputes database framework and content, the preparationof the expert advisory table. Set up an expert forecasting group, select consultantsaccording to the views of the forecasting group, and according to the consultant’s threereplies, statistic and analyze the views and suggestions of consultants.(2) comprehensive literature analysis and expert discussion on the basis of thepreliminary development of database functionality, framework and content.(3) consultants to the payment of the first round of expert consultation form, summary,finishing the first round of expert advice and recommendations, made the second round ofconsultation questionnaires, expert advice, recommendations and analyzed as referencematerial resent distributed to experts for expert analysis and judgment, to put forward a newargument views. The second round of the results of statistical analysis, the third round of consultation, the final convergence of views, get a more consistent and high reliability ofthe database structure and content.5. The medical dispute database was developed based on the SQL2000, withJavaScript and other programming languages to develop applications.6. Through registering and analyzing trauma data from Ophthalmology of a ThreeGrade Hospital in Chongqing. The Performance of the database in registration and analysiswere checked to preliminarily discuss the condition of medical disputes.Results:We developed a database with the content and structure of medical disputes. Thecontent of the database involved6parts:(1) Hospital profile: Hospital name, grade, hospital ownership, hospital type, numberof beds, annual outpatient, hospital asylum visitors, the number of annual operations,address.(2) Department: name of the department, annual surgery, number of beds, titles and thenumber of doctors at all levels, titles and the number of nurses at all levels, health care, theratio of beds to nurses.(3) General condition of patients: patients with general demographic data, ID number,means of communication.(4) Clinics care: treatment date, admission date, the initial diagnosis, final diagnosis,final diagnosis of the date of the first few times of admission, type of disease, the admissionforms, select the cause of hospital medical care, treatment, surgery, hospitalization duringthe highest care level, past history, family history, length of stay, charges do not, the cost ofhospitalization, discharge, patients and their families with medical and nursing servicesatisfaction.(5) Understanding of the disease of patients and their families: patients and theirfamilies understanding of the severity of disease, knowledge of disease, diseasecomplications; expectations of disease, response to the disease; access to information ondiseases of the way, temperament, type of hospital charges.(6) Dispute：①the general information of doctors and patients., the degree of predictability of thedispute, the response to stressful events and processing capacity, whether or not accepted the doctor-patient communication training and training methods, and training content.②When the medical dispute happened and resolved？How long did it last? Howmany staff were on duty at that time? And how many people were treated at that time?Complained or not? The complaint way. How many people visited? Complaint times andlocation, type and reasons and extent of medical dispute,handler duties incident, process,suffering from the request, solution, result, resolve sector, parties satisfaction with theresults.2. According to the database structure and content of Delphi method to determine themedical disputes, a registry and administration system of medical database was developed,with functions of security authentication, data management, input and output and statisticalanalysis and with data registration mode of Browse/Server.3.35cases of medical dispute data were entered and analyzed, and it proved that thisdatabase can collect medical dispute more comprehensively, effectively. And the databasehad capacity of administrating and analyzing data.4. By the analysis of medical records, the general rules and characteristics ofOphthalmology of one grade three hospital in Chongqing were revealed. It provided areference of early disputes warning mechanism for the department.Conclusion:Conclusions: It is proved，by developing medical dispute database and registering andanalysing medical dispute data based on interview, expert discussion and Delphi methodthat it is feasible to establish a medical database suitable to the current state andrequirements of medical dispute. The medical database serves the prediction of Medicaldispute, the methods for the front workers, the training and management from the leaders,the building of prediction system for hospitals and original materials of the research ofmedical dispute.