Characteristics of Female Plastic Surgery Patients with Medical Disputes: Implications for Physician-Patient Communication

Abstract

目的 從整形美容外科醫療爭議之女性患者特性,探討醫病溝通之加强與改善。方法 以2002年1月至2006年12月,臺北市某區域醫院所有接受過整形美容自費手術的女 性患者為研究母體,從病歷資料篩選醫療爭議之患者,並分析其醫療爭議與患者特性 。結果 在所有1,735位接受過美容手術的患者中,共有 13人曾有醫療爭議,最後 進入司法訴訟程序者,共有4人(26.7%)。而13位醫療爭議患者中,有61.5 %為離婚者 ,接受全身麻醉手術者為 76.9%,有精神科過去病史者占61.5%,教育程度大專以上 占53.8%,接受療程前沒有聽過醫師任何訊息者占46.2%,舉債或借錢來整形者占 38. 5%,整形病史豐富者占26. 7%,之前有過任何醫療糾紛經驗者占15.3%。且2002年至 2006年之醫療糾紛的發生呈下降趨勢。結論 醫療爭議發生率為0.74%,醫療訴訟發 生率約為0.23%。本研究建議宜考量患者特性以加强手術前醫病溝通。Objectives: We investigated the characteristics of plastic surgery female patients with medical disputes. This study aims to enhance physician-patient communication and identify any implications that affect clinical practice. Methods: The target population consists of all female patients receiving cosmetic surgery who had medical disputes from a Taipei City District Hospital. The information was collected from January 2002 to December 2006 using medical chart records. Descriptive data was used to analyze the patients' characteristics. Results: A total of 1735 female patients received cosmetic surgery at the chosen hospital and among these individuals, thirteen patients had a medical dispute and four patients (26 .7%) sued their plastic surgeon. Of the thirteen patients involved in a medical dispute, 61.5% were divorced; 76.9% received the operations under general anesthesia; 6.5% had a hi story of psychiatric clinic visits; 53.8 % had junior college education or above; 46.2% had heard about their doctor before seeking the operation; 38.5% had borrowed money to pay for their surgery ; 26.7% had received at least three previous cosmetic operation experiences and 15.3% had a history of medical dispute. Medical disputes showed a decreasing trend from 2002 to 2006. Conclusions: The incidence of medical dispute and litigation during the study period were 0 .74% and 0.23%, respectively. Our study revealed that we should take the patient's characteristics into consideration in order to enhance preoperative communication with their health care provider.