| Objective:To describe the present situation of medical disputes and medical liability insurance implementation in Xuzhou City, analyze the main reason of medical disputes and the problems in the implementation of medical liability insurance and put forward several corresponding countermeasures, and provide a reference for medical institutions to improve doctor-patient relationship in the future.Methods:We selected 24 hospitals as objects and used cluster sampling method to obtain information about property, medical disputes and medical liability insurance participation of these institutions was obtained by in-depth interview.718 on-duty medical personnel accepted our questionnaire survey which include demographic and social data, medical disputes occurred from March 2013 to February 2014 as well as the causes and handling. Medical liability insurance participation of these hospitals and medical individuals and the causes of non-participation and their attitudes about medical liability insurance were also inquired. SPSS 13.0 was used to set up database and analyze the data.Result:There were 718 medical workers,406 males(56.6%),312 females(43.4%), with average age about 38.1�2.4 year.52 of them(7.2%) had been involved in medical disputes, and 34 has encountered with violence. Male doctors, younger than 35 years old, work seniority less than 5 years and doctors hold junior professional post are easier to be involved in medical disputes.38 cases(11 cases of Obstetrics) occurred in surgical system, accounting for 59.4%; 19 cases(12 cases of Internal Medicine-Cardiovascular Department) in internal system, accounting for 29.7%; 4 cases in medical assistant department, accounting for 6.25%; 3 cases in the other departments, accounting for 4.7%. The medical disputes about medical malpractice were the most (35.9%), followed by the "poor communication between doctors and patients"(23.5%), and the third problem is the "non understanding of the patients and their relatives"(15.6%). The main ways to solve the problem were by mutual consultation between doctors and patients (60.9%), by people's court litigation settlement (35.9%) and the health administrative departments of mediation (3.2%), respectively.Nine medical institutions have participated in the medical liability insurance, with the insurance rate of 37.5%. The rates of public hospital and private hospital were 3(23.1%) and 6(54.6%) respectively. General hospital and special hospital were 2(22.2%),7 (46.7%), respectively. Primary, secondary, tertiary hospitals were 1 (33.3%), 6 (54.6%) and 2 (20.0%), respectively. There were 476 medical workers of the hospitals non-participation in the medical liability insurance. Of them,21(4.41%) participated insurance in the name of individual. Medical workers who experienced violence or medical disputes were more inclined to participate in the insurance than the other workers. Among 697 medical workers who didn't attend the medical liability insurance, 382(54.81%) didn't know about it,203(29.12%) reported there was no need,38(5.45%) considered about the cost,31(4.45%) expected low-compensate,29(4.16%) thought the procedure was too complicated, and 2(0.29%) worried about disadvantage selectivity of the insurance company.There were 399 people(55.57%) reported they did not know about the medical liability insurance; only 319 people (44.43%) reported knowing about it. After understanding the medical liability insurance,71.73% of the medical staff from the 718 persons thought it was necessary to participate in medical liability insurance. On the choices of the costs of insurance, there were 55 medical personnel(27.1%) could not make a choice, because they did not understand the relevant insurance knowledge.63 cases (31%) of them were willing to come up with 1% years of wages; 46 cases (22.7%) were willing to come up with 2%-3%; 39(19.2%) of the medical staff were willing to come up with 4%-5%.Conclusion:The incidence of medical disputes in Xuzhou is relatively high. It mainly occurs in clinical departments particularly the surgical department, male, younger, shorter length of service and lower title of medical personnel. The proportion of resolving medical disputes through consultation is the highest, and the lowest proportion is administrative organs. The main causes of the disputes are the medical technology level, medical quality problems caused by medical damage, poor communication between doctors and patients and patients'not understand. The rate of medical insurance and medical personnel's personal initiative is lower. The main reason is the low rate of knowledge awareness. Therefore, the strategy of preventing medical disputes should be based on the improvement of the quality of medical treatment, and constantly strengthen the communication between doctors and patients, and resolve the differences and conflicts between doctors and patients in time. At the same time, in order to improve participation enthusiasm of health care institutions and medical personnel, the relevant departments should issue some policies and provide financial support, as well as carry out medical liability insurance application value propaganda; insurance agencies should provide convenient services and simplify settlement of claims procedures. |
PDF Full Text Request