醫療糾紛與醫療品質相關性之探討; A Study of The Relationship Between Malpractice and Health Care Quality

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题名:	醫療糾紛與醫療品質相關性之探討;A Study of The Relationship Between Malpractice and Health Care Quality thesis
作者:	江怡如;Yi-Ju Chiang
贡献者:	中國醫藥學院醫務管理研究所
关键词:	醫療糾紛;醫療品質;德菲技術;Medical Malpractice;Health Care Quality;Delphi Technique
日期:	1990
上传时间:	2009-12-03 09:20:02 (UTC+8)
摘要:	隨著民眾教育與生活水準、權利意識的提高，使得醫病關係由傳統完全為醫師是從的不平等觀念漸漸有了改變。當民眾在接受醫療照護時，對醫療品質的重視與期待越來越高，若醫療機構與醫療人員沒有提供滿足病患的醫療服務，必會使得醫療糾紛的發生增加。本研究即是希望能瞭解醫療糾紛案件之發生與醫療品質間的關係為何？以德菲技術為研究方法，邀請12位兼具醫療與醫務管理專業之內、外、婦、兒科臨床醫師，對本研究所收集之371個醫療糾紛案件進行兩回合的分析。本研究顯示，醫療糾紛之發生與醫療品質呈現很高的相關。而與醫療糾紛發生相關之醫療品質類型以「醫師素質、專業訓練相關」、「結果與病患或家屬期望不符」、「併發症、合併症的發生相關」、「與病患或其家屬溝通不足或不良相關」四者比率最高，顯示醫師對自身專業能力的充實、與病患有良好的互動，皆是避免醫療糾紛發生的有效預防之道。此外，醫療機構持續改善醫療品質、從事各項醫療品質管理活動對避免醫療糾紛的發生亦有正面的助益。若醫療機構能加強與病患的溝通、詳盡的為病患解釋病情、並持續做好醫療品質管理工作，將是最有效且最經濟的方法。最後建議後續研究者，可以針對民眾對醫療機構提供之醫療品質滿意度的看法進行分析，從病患層面探討可能產生醫療糾紛的潛在因素，對預防醫療糾紛的發生應更有幫助。; With increase in the educational level, living standard and the conscious of right, the relationship between physicians and patients has been changing. Patients do not comply with the physician’s opinions as usual. They expect higher health care quality more than before. So, the number of malpractice will increase, if medical organizations and staffs do not offer the services which meet patient’s expectation. This study examined the relationship between medical malpractice and health care quality. Twelve physicians, who have health management knowledge and experience, were hired to evaluate each malpractice case. This study proceeded two rounds of Delphi Technique to analyze 371 medical malpractice cases. According to survey results, the relationship between medical malpractice and health care quality is strong. The 「Physicians’ quality and professions」,「Not acceptable outcomes」,「Complication and Comorbidity」,and「Inadeguate communication between physicians and patients」have higher relationship with medical malpractice. This implies that physicians should increase their professional skills and knowledge and should have adeguate communication with patients is the best way to avoid medical malpractice. Medical institutions continuously improve health care quality and proceed all kinds of health care quality managerial activities, which can avoid medical malpractice happening. That is the most economical way, if medical institutions can strengthen communication with patients, clearly explain patient’s condition, and promote health care quality managerial activities continuously.
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