Case Study On Third Party Mediation Of Dispute Between Doctors And Patients In Drum Tower District Of Nanjing

Purpose:In recent years, the contradiction between doctors and patients presented a rising trend, and the violence of medical incidents continued to exposure. To establish a great processing mechanism of doctor-patient dispute and resolve the disputes reasonably, to build up a harmonious relationship between doctors and patients and a good medical order is the inexorable requirement for deepening the reform of medical and health system and even building a harmonious socialist society. This paper focuses on 801 cases of medical disputes from doctor-patient dispute people’s mediation committee in Drum Tower District of Nanjing, carries on the analysis to the medical dispute cases to understand the distribution situation and characteristic of these cases, Finding out the factors which affect the success rate of third-party mediation and compensation for patients from patients, hospitals, dispute and medical mediation committee four aspects. This paper also finds out the confusion of patients, hospitals and medical mediation committee, explores the work and confusion of the third-party mediation, proposed some suggestion finally.Methods:Firstly, the author consulted the domestic and international literature on the third-party mediation of medical disputes, and studied the current development of foreign and domestic and present patterns of various countries and regions. Then the author carried on statistical calculation of related data in 801 cases and developed quantitative or qualitative statistical items, such as hospital level, whether the patient need to have a surgery, patients with or without medical identification, patient’s current condition, the amount of compensation. The data of these cases was saved through EPIDAEA 3.1 and analyzed by SPSS 20.0. The specific statistical method applied in this paper mainly included descriptive analysis, Fisher exact test, Mann-Whitney U test, independent samples. Finally, an interview was conducted for patients, hospital and medical mediation committee.Results:(1) In the total of 801 cases,625 cases of medical disputes happened during the process of surgery, accounting for 78%. Only 5.9% of the medical disputes have been identified, the proportion is too low. (2) Medical mediation committee solved 790 medical disputes successfully. Mediation success rate is 98.63%. Patient’s situation, the rank of the hospital and different department have no significantly difference in the influence on the success rate of mediation; when it comes to patients with or without medical identification, mediation success rate of people’s mediation of disputes was 93.6% and 99.1% respectively, the difference is statistical significant (P=0.017), the success rate of face to face mediation and telephone mediation of medical mediation committee were 99.1% and 90.6% respectively, the difference has statistical significance (P=0.006). (3) Among the 790 medical disputes, the average amount of compensation form hospital is 73 thousand and 700 yuan, the total amount of compensation is 58 million 286 thousand and 200 yuan. Main factors that influence the amount of compensation for patients is the medical treatment process with or without surgery, different departments, the patients with or without medical identification, and the attitude of doctors towards accident liability.Conclusion:The characteristics of the medical adjustment disputes:surgery is an important factor of medical dispute; medical identification accounts little proportion; high success rate and less influence factors; the amount of compensation is affected by many factors. The work of medical mediation committee achieved some effects, but there are still some confusion, such as lack of power of investigation and identification which is conferred by law, legal effect is not clear, lack of adequate professional personnel and funds. In order to better solve the disputes between doctors and patients, the authors suggest:(1) patients:when the patients encounter medical disputes, it is necessary to change from passive to active; seek helps form third-party mediation actively; be reasonable when faced of medical disputes. (2) hospital:first of all, to strengthen the management of medical quality, ensure medical safety, reduce the occurrence of medical disputes from the source; solutions for medical disputes should be diversified; to establish transfer mechanisms with the third-party mediation and public security organization. (3) the third-party mediation committee:strengthen its propaganda; establish advisory body of legal aid, and business contacts with identification bodies; compulsory medical liability insurance.The author also advised the government to increase financial support to medical mediation committee.