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目的了解发生医疗纠纷的常见原因,为制定防控策略提供依据。方法收集2010—2014年三明市医疗纠纷资料,核查并统计分析。结果 5年共发生医疗纠纷案53起,年均递减率17.2%。案件以三级医院(92.5%)为主,外科(34.0%)、内科(22.6%)和儿科(20.8%)发生较多;患者年龄多为儿童和中青年(<10岁占24.5%,20~49岁占54.7%),涉及农民工的案件占69.8%。原因以沟通不到位为主(43.4%),诊疗行为过失15起(28.3%),技能水平不足10起(18.9%)。通过完善第三方调解机制、加强医患沟通等干预措施,展开“法、理、情”全方位调解,医疗纠纷均得以顺利调解。结论完善调解机制、加强医患沟通技巧、提高技术水平和加大医疗质量安全管理,是处置医疗纠纷的关键。
Objective To understand the common causes of medical disputes and provide the basis for making prevention and control strategies. Methods The data of medical disputes in Sanming during 2010-2014 were collected, verified and statistically analyzed. Results A total of 53 medical malpractices occurred in 5 years, with an average annual decline rate of 17.2%. The cases were mainly tertiary hospitals (92.5%), with surgery (34.0%), internal medicine (22.6%) and pediatrics (20.8%). The patients were mostly young children and middle-aged patients (<10 years old, 24.5% ~ 49 years old accounted for 54.7%), involving 69.8% of migrant workers cases. The main reasons for this were poor communication (43.4%), negligence of 15 (28.3%) in diagnosis and treatment and skills (less than 10 cases) (18.9%). Through the improvement of third-party mediation mechanism, strengthening of patient-patient communication and other intervention measures, the “law, management and intelligence” all-round mediation, medical disputes were successfully mediated. Conclusion It is the key to dispose of the mediation mechanism, strengthen communication skills between doctors and patients, improve the technical level and strengthen the management of medical quality and safety.