https://scholars.lib.ntu.edu.tw/handle/123456789/192290
標題: | 外科醫療糾紛案例分析 | 作者: | 林明燦 | 關鍵字: | 外科醫療糾紛;和解 | 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: | 科技之快速發展,近年來新手術方法與人工器官等醫學技術已由單純之醫學 研究發展到臨床測試與運用,並進而直接的造福病患,大家都預期會延長壽命。 然而,在台灣,這些非傳統的醫療科技要用在人的身上,卻因為法律設計的問題, 變成種種的醫療糾紛。根據民國50 年以來的衛生署行政命令,對於醫療執業行 為、過失責任認定多有改變,結果根據陳榮基教授報告1991 年一年台灣的醫師 因此直接賠償病人約兩億七千萬新台幣,時間成本、請託費、律師費約有三億七 千萬新台幣,並發現防衛性醫療增加,對於重症病人服務變差;台灣人若要在台 灣生重病,可能要先解決重症醫療品質不良的問題,先分析最近醫療糾紛案例用 來找到現今問題的癥結是迫切需要的。 在本計畫中,第一部份分析最近五年在北部中部數個醫學中心及準醫學中 心、台灣外科醫學會所彙集的醫療糾紛案例,有54 例外科醫療糾紛的案例,對 於年齡、性別、疾病嚴重性、手術傷害分類、投訴時間、投訴訴求、外力介入、 糾紛成因、因果關係、外科醫療糾紛下外科醫師的結果(民事責任、刑事責任、 賠償金額、時間成本、黑道及白道參予有否)病人的結果等等加以紀錄及做分析; 第二部分問卷部分,以一般民眾、法律人士、外科醫師,資料以SPSS 統計軟體 分析。 第一部份分析發現,54 例外科醫療糾紛案例,病人年齡平均51.7 歲( 0.8 – 89 歲 ), 男女比為55.6%比44.4%,家屬多為預期過高醫療效果者(健康自評61.1%,投訴 動機 64%)、要求賠償為最高選項(40%)、外力介入過半為民意代表(53% )。第二 部分問卷一般民眾863 人、法律人士 340 人、外科醫師857 人, 和解機制為一 般民眾及外科醫師最能接受的醫療糾紛解決方式。 研究結果發現,最近5 年發生的外科醫療糾紛可能多來自認知差距及民意代 表介入索賠,問卷調查顯示強化和解機制可能為最能接受的醫療糾紛解決方式。 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 disputes evaluation system covering surgical practice in nontraditional roles( e.g. new techniques trial, artificial implants risks, usage evaluation) was not well developed in Taiwan. Our government had different rules about surgical disputes. In 1991 Chen et. al reported that doctors paid more than 270 million NTD to their patients for the disputes. Professor Chen also reported defensive medicine the percentage of defensive medicine increase because of rules uncertainty. If Taiwanese wanna develop new rules to clarify surgical disputes in Taiwan. It is necessary to review the surgical disputes in the recent years. In this plan, we analysis the recent five years surgical disputes at the medical centers and procenter in the north and middle part of Taiwan, and Taiwan Surgeon association. About 54 cases was found with surgical disputes. Age, sex, severity of diseases, surgical damage classification, suing timing, suing cause, external force involving, plural causes, truth- consequence, result of the doctors under surgical disputes ( civil liability and criminal responsibility, money paid, time wasting, gansters involving ), result of the patients were recorded for statistic by the SPSS software. In this study , legal disputes caese analysis showed the average age of the patients was 51.7 year-old ( 0.8 to 89 year-old), sex ratio was 1.25 ( male : female = 55.6: 44.4 ) , most family had overweight effect about surgery ( health self-evaluation 61.1%, sue motive 64 % ), most family asked money compensation(40%) , lawmakers involving for the compensation over 50% ( 53 %); questionnaire included Taiwanese folk 863, legal workers 340, and surgeon 857 . Negotiation was the favorest option for Taiwanese folk and surgeons. In conclusion, most surgical disputes in the recent 5 years might be related to recognition difference and lawmaker involving the compensation procedures. The questionnaires showed enforcing negotiation mechanism was the favorest option for our Taiwanese folk and surgeons. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/24515 | 其他識別: | 912420H002025 | Rights: | 國立臺灣大學醫學院外科 |
顯示於: | 醫學系 |
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912420H002025.pdf | 218.11 kB | Adobe PDF | 檢視/開啟 |
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