https://scholars.lib.ntu.edu.tw/handle/123456789/192289
標題: | 外科新醫療科技之發展與醫療風險之界定及分擔 -外科醫療風險之檢討與再界定(總計劃)- | 作者: | 張金堅 | 關鍵字: | 外科醫療風險;疾病嚴重度;風險分擔;醫事法 | 公開日期: | 31-七月-2003 | 出版社: | 臺北市:國立臺灣大學醫學院外科 | 摘要: | 外科新醫療科技之發展,已直接的造福病患,大家都預期會延長壽命。然而 延長壽命的同時,外科新醫療科技也有和傳統手術不同的風險,在台灣,這個風 險定義仍不明確;根據長庚醫院1998 年1 月實施案病例計酬的風險分擔管理制 度,醫院將責任交給醫師,用醫療成本的減少來回饋醫師並分擔風險,結果輕病 賺錢且風險少變成醫療供給者的共識,和民眾期待重病醫療品質提昇的想法,出 現落差。為了明確定義、符合民意,對台灣社會的了解有必要落實,從醫療糾紛 案例、人體試驗、刑事責任、民事責任、責任保險、健康保險各個面向,進行檢 討。 在本計畫中,主要工作項目有二: 1) 分析外科醫療風險2) 再界定外科醫療 風險,根據風險分擔原則,提出台灣社會提昇醫療品質的建議。 參予人員設法提出較符合民意需求和統計科學的解套方法,提出不同疾病嚴 重程度的加權指數,針對外科醫療新科技之發展,找到民眾、醫療提供者雙贏的 對策。 本研究是要用法學、社會學及外科學的專業,增加台灣社會外科醫療風險管 理的處理透明度,保護病人權益是我們最終的目的。 According to the rapidly evolving of surgical new techniques and artificial implants, it was said that the 21st Century would prolong life expectancy. However, surgical risk definition system covering surgical practice in nontraditional roles( e.g. new techniques trial, artificial implants risks) was not well developed in Taiwan. Chang Gung Memorial Hospitals carried out risk sharing management in Jan. 1998 as response to the impact of Case Payment Policy. Physicians will be rewarded as the medical expenditure of their patients below amount paid by National Health Insurance. They focused on the money. However Taiwanese care more about quality. There is a gap between Taiwanese and medical suppliers. In order to redefinite the surgical risk, it is necessary to understand the definition of Taiwanese society in case studies, human clinical trial, criminal responsibility, civil liability, liability insurance, and health insurance.The major items of this study are two-fold: 1) to analyze surgical risks 2) to redefinite surgical risks. According to the principle of risk sharing, surgical risk will be redefined to meet the real need of Taiwanese society - surgical quality improvement. Analyzing the data of other daughter plans in this study, members will design a new definition that was developed from Taiwanese society and Statistics. The relative weights for different types of diseases will be developed. With respect to co-morbidity and complications, the new definition will cover the impacts on advance surgical technique. In summary, the scopy of study is based on the profession of social science, law and surgery.The study would provide the transparency about surgical risk management in the Taiwanese society. The advance for patients' protection is our goal. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/24514 | 其他識別: | 912420H002021 | Rights: | 國立臺灣大學醫學院外科 |
顯示於: | 醫學系 |
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912420H002021.pdf | 780.24 kB | Adobe PDF | 檢視/開啟 |
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