———对东莞市4家基层医院的调查

李大平

【摘 要】 我们采用历史数据、意向问卷调查、文献评阅及专家咨询相结合的研究方法，对于采访的定性资料，采用引语方式描述，共调查了东莞市4家医院2007-2011年间发生的 260起医疗纠纷。研究发现：医患关系总体上患者比医生持更加乐观的态度；医疗纠纷大多自行和解，行政调解和诉讼均为少数；医疗纠纷大多没有进行鉴定，在鉴定中有选择医疗事故技术鉴定，有选择医疗过错司法鉴定，二元化鉴定是医闹的重要根源；医疗纠纷中医方的原因仍然是主要原因；医疗纠纷主要发生在治愈和好转的患者身上，纠纷发生率并不与患者病情情况有直接相关；医疗纠纷对医生行为产生严重影响，大多数医生采取防卫性医疗措施；产生医疗纠纷的两大根本原因是医疗体制缺陷和医疗纠纷解决渠道不畅。 传统的医患和解、卫生行政部门调解以及诉讼渠道都存在难以克服的缺点，为此要构建医事仲裁制度。

【关键词】 东莞；基层医院；医疗纠纷；医疗事故；医事仲裁

【中图分类号】 D922.16

【文献标示码】 A

【文章编号】 1674-1226（2013）01-0199-16

The Survey Report on the Medical Disputes in the Four Primary Hospitals in Dongguan. Li Daping.Guangdong Medical College Dongguan 523808, Guangdong.

【Abstract】 Using the combined research method of historical data, intention questionnaire, literature review and expert consultation, the author describes the interviewed qualitative data and surveys 260 medical disputes taking place from 2007 to 2011 in the four hospitals in Dongguan. The research concludes as followed:Patients hold a more optimistic attitude than doctors in terms of the doctor-patient relationship. Medical disputes mostly tend to be settled peacefully rarely using administrative mediation and litigation. Most medical disputes are not identified; if identified, there exists an option of medical accident technology identification and medical fault judicial identification, so binary medical identification is the key root for medical trouble. Medical party is still the main reason in medical disputes. Medical disputes occur mainly in cured and improved patients and dispute rate is not directly related to the patient’s condition. Medical disputes have serious effects on the conduct of doctors,and most doctors take defensive medical treatment. The two basic reasons for medical disputes are the flaw of the medical system and the less smooth solution channel for medical disputes. Since the traditional doctor-patient reconciliation, the mediation conducted by the health administrative institution and the litigation channel are difficult to overcome these shortcomings, it is very necessary to build a system of medical arbitration.

【Key Words】 Dongguan, Primary hospitals, Medical disputes, Medical accident, Survey，Medical arbitration.