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There are many deficiencies of the current medical accident insurance in China. Learning from the foreign no - fault compensation system for medical injury,combining with China's reality,it could be done as fol-lows:establishing a mandatory medical accident insurance system through legislation;bringing premiums into health insurance co - ordination;simplifying the claims process and increasing claims quota;standardizing the sales chan-nels. Medical accident insurance and medical liability insurance complement each other,so that the losses of pa-tients achieve effective relief compensation through insurance,effectively easing the tense relationship between doc-tors and patients.
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Objective: To explore the effect and significance of medical dispute mediation committee as third party participating in pre - operative testimony mechanism. Methods: For 116 operations from Oct 2015 to May 2017, the medical dispute mediation committee as third party witnessed preoperative communication to patients and their families and signature, and we put forward suggestions for risk guarantee. Results: There were no medical disputes in any of the witness case, of which 43 cases purchased medical accident insurance and achieved risks transfer. Conclusion: Medical dispute mediation committee as third party participating in pre - operative testimony mechanism helps both doctors and patients clear risks, supervises the fulfillment of informed consent, promotes the landing of medical accident insurance, and achieves the recognition and transformation of medical risks.
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This paper introduced the development of medical accident insurance at Tianjin Medical University General Hospital. The author summed up the achievements made in practice and analyzed the problems such as low risk awareness of the patients in their low proportion of insurance risk coverage ,lack of normalized industry standards ,and lack confidence. Other problems include the lack of top-level design of the system ,and high difficulty to plan insurance projects. The paper also recommends to strengthen the positive publicity and guidance ,to create a healthy atmosphere of public opinion;to improve the system ,standardize the industry supervision ;and encourage the introduction of policy proposals ,and to perfect the national medical risk sharing and compensation mechanism .
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Devido às profundas mudanças económicas e sociais na China a prestação de cuidados de saúde enfrenta sérias dificuldades para satisfazer as necessidades dos pacientes, conduzindo, pois, a frequentes conflitos entre pacientes e médicos e/ou estabelecimentos de cuidados de saúde. Uma vez que os tribunais comuns parecem incapazes de resolver os litígios médicos de uma forma considerada satisfatória para ambas as partes, o Governo Chinês criou os tribunais do acidente médico. Estes tribunais são caracterizados por duas notas principais: por um lado a sua composição, dado que, e ao contrário dos tribunais judiciais, são compostos por decisores com conhecimentos médicos; por outro lado, o facto de a actividade dos tribunais do acidente médico se restringir ao campo da responsabilidade médica, sendo que esta especialização lhes permite decidir os casos de uma forma mais expedita e supostamente mais justa. Contudo, e apesar do grande desenvolvimento representado pelos tribunais do acidente médico, eles representam apenas uma pequena peça da grande reforma exigida pelos conflitos médicos que têm lugar por toda a China
Due to deep economic and social changes in China health care delivery faces severe difficulties in order to satisfy the patient's needs, thus leading to frequent conflict between patients and health care facilities and/or doctors. Since regular courts seem unable to solve medical litigation cases in a way considered satisfactory for both parties Chinese government created the so called "medical accident tribunals". These courts are characterised by two main notes: on the one hand, their composition, since, unlike regular courts, they are composed by deciders with medical expertise; on the other hand, the fact that the activity developed by these courts is restricted to the field of medical liability, thus, this specialization allows them to decide faster and supposable in a more just way. However, and despite the main development that medical accident courts represent, they are just a small piece of the main reform required by medical conflicts around China.
Debido a los profundos cambios económicos y sociales en China la prestación de atención de salud está enfrentando serias dificultades para satisfacer las necesidades de los pacientes, lo que lleva a frecuentes conflictos entre pacientes y médicos y/o centros de salud.Desde los tribunales ordinarios parecen incapaces de dar solución a las controversias médicas de manera satisfactoria, el gobierno chino ha creado los tribunales del accidente médico. Estos tribunales se caracterizan por dos notas claves: por un lado, su composición, que están compuestas por los encargados de la adopción de decisiones con conocimientos médicos; por otro lado, el hecho de que las actividades de los tribunales del accidente médico si restringir el ámbito de la responsabilidad médica, y que esta especialización les permite decidir los casos de manera más rapida y e más justo. Sin embargo, y a pesar del gran desarrollo representada por los tribunales del accidente médico, sólo representan una pequeña parte de la gran reforma médica requerida por los conflictos que tienen l en China.
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Se parte de una descripción doctrinaria de la noción del álea o riesgo médico, que conduce a identificar los sentidos que adopta, a fin de confrontarla con la noción de la culpa médica. De manera más específica, se intenta también perfilar una noción de error médico que se va posicionando en el derecho médico, no obstante ser objeto de diversos estudios en el campo de la medicina. El objetivo del estudio consiste en tratar, desde la perspectiva del derecho comparado, el problema que comporta la noción del riesgo médico para el terreno de la responsabilidad civil, el cual se abordará a través de un examen de la jurisprudencia comparada, que evidenciará los pasos que se vienen dando en diversos sistemas jurídicos, entre ellos el colombiano, para extender las reglas de la responsabilidad al campo de lo contingente, sin perjuicio del reconocimiento de alguna opción legislativa clara para regular las consecuencias de lo que se viene a conocer por accidente médico.
This article starts with a doctrinary description of the therapeutic alea or medical risk leading to an identification of the senses it adopts for the purpose of confronting it with medical fault or negligence. In a more specific way, it also aims at outlining a notion of medical error that is beginning to take a position in medical law, despite having been the object of diverse studies in the field of medicine. The objective of this study lies in attempting, from the perspective of compared law, to deal with the problem implied in the medical risk notion for the field of civil liability, which will be addressed through an examination of compared jurisprudence examination that would evidence the steps being taken in various juridical systems, including Colombia's, to extend the rules of liability to the contingency field without prejudice to the acknowledgement of a clear legislative option used to regulate the consequences of what has come to be known as medical accident.
O estudo começacom uma descriçãodoutrinária da noção do risco médicas, que leva a identificar os sentidos que adota, a fim de confrontá-la com a noção da culpa médica. De um jeito mais específico, pretende-se também perfilar uma noção do erro médico que é posicionado no direito médica, apesar de ser objeto de estudos diversos no campo da medicina. O objetivo do estudo consiste em tratar, desde a perspective do direito comparado, o problema que comporta a noção do risco médico para o terreno da responsabilidade civil, que se abordará através da examinação do jurisprudência comparada, que demonstrará as etapas dos diversos sistemas legais, entre eles o colombiano, para estender as regras da responsabilidade ao campo do contingente, sem prejuízo do reconhecimento de alguma opção legislativa clara para regular as consequências de aquilo conhecido como acidente médico.
Subject(s)
Medicine , Biopharmaceutics , Civil Rights , RiskABSTRACT
Medical liability insurance is a latecomer in China,and faced with many challenges ever since.This paper picked medical liability insurance in Nanjing as an empirical study example,as the author analyzed the insurance,underwriting and premiums of medical liability insurance,as well as the insurance programs and claim settlements from 2008 to 2012.In addition to noting problems found in medical liability insurance in Nanjing,the author proposed the roadmap for China' s medical liability insurance,with reference to experiences of overseas medical liability insurance industry.
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There has been a great deal of concern about medical malpractice in Korea. Exact figures are difficult to determine, but medical accidents or disputes have increased since the late 1980's. Since 1988, there have been various legislative attempts to pass the 'Medical Dispute Adjustment Act', a kind of alternative dispute resolution. Finally, in March 2011, the mediation law was enacted. The purpose of this law is to create a rapid, efficient recovery system for patients, and to provide a safe, stable environment for medical personnel. Even though medical accidents are inevitable, like other accidents, of course neither doctors nor patients wish for them to occur. However, the medical system lacks an alternative solution for promoting a rational process for communication about medical accidents. As a result, violence against doctors and occupation of medical institutions are more common than they could be. Meanwhile, the Supreme Court has alleviated the burden of proof in medical disputes by applying the theory of prima facie evidence to protect the rights of patients. Though the Supreme Court's position is reasonable in terms of patient care, these cases could lead to 'defensive medicine'. This phrase refers to treatments motivated more by the reduction of liability than by medical needs. This means an increase in health care costs. Above all, civil litigation requires a great deal of time for both parties. Consequently, if medical accidents are inevitable, medical personnel should respond proactively to accidents rather than concealing them. The social recognition of medical malpractice must change in order to create an effective adjustment system and prevent as many medical accidents as possible.
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Humans , Defensive Medicine , Dissent and Disputes , Health Care Costs , Human Rights , Jurisprudence , Korea , Malpractice , Negotiating , Occupations , Patient Care , ViolenceABSTRACT
[Objective]To aleviate incidents and prevent medical accidents in acupuncture and moxibustion therapy, we constructed an incident report (IR) system at the Center of Acupuncture Science, Meiji University of Integrative Medicine.<BR>[Methods]The IR system was operated with the center staff as reporters. The staff reported incidents when encountered or found. The cases of incidents were added up per item, and the contents of incidents fed back per month to staff and students. The feedback was given orally at a morning assembly, and a feedback poster was put up.<BR>[Results]There were 146 cases from July 2004 to September 2005. The contents of incidents were 96 cases concerning the environment of treatment, 0for incidents before treatment and 50 during or after treatment. The largest number of incidents in the environment of treatment was 66 cases for inappropriate disposal of instruments. The largest number of incidents during or after treatment was 12 cases in nearly forgetting to remove acupuncture needles from the body.<BR>[Discussion]Ten mean cases per month occurred as incidents. However, it was clear that the incidents in most cases could have been prevented if the acupuncturist had been noticed and took measures to deal with the situation. To prevent medical accidents, we consider a need to continuously feed back the contents of incidents to instructors and students and call them to their attention.
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[Objective]It is important for students to learn in school education how to prevent medical accidents caused by deep insertion of a needle. Also, it is essential in safe acupuncture treatment that students are always reminded there are individual variations in subcutaneous structure and to confirm the position of the needle tip in the subcutaneous tissue. To recognize the acupuncture needle tip, muscle twitch induced by electrical stimulation through the acupuncture needle tip was felt with fingers of training students. <BR>[Methods]To prevent accidental pneumothorax, acupuncture training was performed in the upper and lower extremities. After the class, we conducted a questionnaire investigation with the students.<BR>[Result]As the result, students realized that the position of the needle tip which they assumed is different from the real position in subcutaneous tissue.<BR>[Discussion]Without knowing the precise position of the acupuncture needle tip, a desirable effect is not provided, and furthermore, a medical accident may be caused. It is important to confirm the position of the acupuncture needle tip with consideration to individual variation for safe and effective acupuncture treatment. <BR>[Conclusion]We concluded that the skill to prick and insert the acupuncture needle to the correct position is so important in preventing medical accidents that training to learn correct needle tip position should be given in acupuncture education.
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BACKGROUND: Obstetrics departments are unique and medical accidents in obstetric anesthesia may show differences from non-obstetric anesthesia accidents.So we compared both groups in several aspects for the understanding their characters and decreasing their incidence. METHODS: Obstetric anesthesia accidents (n = 30) and non-obstetric anesthesia accidents (n = 106) were compared in 6 categories (patient age, anesthesia method, damaging event, anesthetic care, severity of injury, payment). RESULTS: The most common complications in obstetric anesthesia accidents were maternal death (40%), maternal brain damage (13%), and maternal nerve injury (13%).In contrast, the most common complications in non-obstetric anesthesia accidents were patient death (62%), and patient brain damage (27%). The severity of injury score of obstetric anesthesia adverse outcomes was analogous to that of non-obstetric anesthesia adverse outcomes, but the payment for obstetric accidents was significantly greater than that for non-obstetric accidents. CONCLUSIONS: Obstetric anesthesia accidents revealed distinct medical risk profiles, such as patient age, damaging event, severity of injury, and payment.Special care should be used when anesthetizing younger women and caring for a newborn in obstetric anesthesia.More studies and analyses are necessary to prevent obstetric anesthesia accidents.
Subject(s)
Female , Humans , Infant, Newborn , Anesthesia , Anesthesia, Obstetrical , Brain , Maternal Death , Obstetrics and Gynecology Department, HospitalABSTRACT
Objective To discuss the medical treatment responsibility caused by unpredictable harm.Method In medical treatment,the court usually applies the "Equitable Responsibility" principle to settle the medical conflicts caused by unpredictable harm,this poses certain limitations.Result The fact that hospitals being liable for compensation or reparation ignores the mutual risk-sharing responsibility of hospitals and patients.Conclusion To establish the system of medical accident insurance is one of the best measure to solve the medical conflicts caused by unpredictable harm.
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OBJECTIVE To realize the timeliness of the mobile phone and network during the application of the infectious disease reporting and supervision,and the preciseness of the infectious disease forecast,thus build the automatic reporting and supervision system of the infectious disease in hospital with the military and local features.METHODS Using the existing iatrical data and computer resources with telecommunication wide band network and the special mobile phone resources to construct the reporting and supervision system of the epidemic situation.Adopting B/S framework,the downstage supporter adopted the comprehensive technology with Net,J2EE,and Java,the backstage supporter adopted the large scale database of Oracle,using software and NTFS with code technology to make epidemic situation reporting and supervise the network.RESULTS This system might realize the most important function of the infectious disease with timely reporting,precise filling,automatic alarming,dynamic supervision and automatic statistical calculation.CONCLUSIONS This system may provide the important practical value for the epidemic situation reporting and supervision and the abrupt public medical accidents forecast.
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The application of the law of medical disputes has become hot debate in law experts and the actual trial with the growing number of medical treatment damages litigation.There has been binary phenomenon of applicable the law of "The Medical Accident Handle Regulation"and the General Principles of Civil Law.The compensation,which is closely related to the law suffered the same problem.The emergence of this phenomenon is inseparable from the shortcomings of "The Medical Accident Handle Regulation".The author will explore the issue and make recommendations.
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As people are more concerned about their and medical care. there have been and increasing number of medical disputes due to increased medical demand. In order to prevent and provide solution to currently surging medical accidents and disputes related to orthodontic treatment, in July 1998, the Korean Association Of Orthodontists surveyed 2.200 members of Korean Association of orthodontists on 30 items to recognize the pattern of medical accidents and prevent them. The survey was about accident-related items including personal profiles of members and patients who have undergone medical accidents or disputes, the cause and solution to the accidents, cautions related to members orthodontic treatment, and medical recording and archival. Based on the survey result we analyzed characteristics of medical accidents and disputes in orthodontic area. It is more important to predict and prevent possible medical accidents or disputes based on current situation than to solve them after disputes occur. For this, we should not be negligent in raising treatment proficiency level based on patient-doctor trust and in obtaining new medical information. We should also provide medical environment where patients themselves can decide whether to get treatment after they are offered detailed explanation on diagnosis, treatment procedure, complication, and possible hazard. We should take caution when treating patients and pay attention to charting and maintenance, which is the most fundamental, as well. Also at the Korean Association and disputes, and actions and organizations that can help when accidents and disputes occur.
Subject(s)
Humans , Diagnosis , Dissent and Disputes , Medical RecordsABSTRACT
After the Statute on Disposing Medical Accident was put in practice,doctors in China are faced with tremendous stress that never faced before.Doctors begin to evade risks with defensive medicine under the stress.There are two types of defensive medicine,one is positive defensive medicine,which will induce to excessive medical treatment for evading risks,another is negative defensive medicine which will lead to nonfeasance in the presence of intensive patients or dangerous diagnosis and treat procedure.Defensive medicine results in inefficiency of medical service and influences patients' safety.How to lessen doctors' defensive medicine will be an important social problem.
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Objective To find out the tendency of medical accident arbitration in 5 hospitals of Shanghai and the causes. Methods Cases involving medical accident arbitration that occurred in the 15 years running from 1985 to 1999 in 5 third tier hospitals of Shanghai were collected and a retrospective correlation analysis was conducted. Then 45 of the cases were selected by random sampling and a detailed analysis was made. Results ①During the 15 years the number of cases involving medical accident arbitration by class 1 commissions was 295, with the average number per year in the latter five years rising 51% as compared with the first ten years. ②There was no significant correlation between the number of cases involving arbitration and the number of cases judged to be accidents. ③There was no correlation, either, between the total volume of emergency outpatient service, which amounted to 68, 6 million visits, and the number of cases involving medical accident arbitration. ④The sample survey showed that the operating room and the emergency room were sections where medical accidents occurred most frequently. Conclusion In the past 15 years, the number of cases involving medical accident arbitration has been on the rise, yet there is no correlation between the rise and the number of cases judged to be accidents or the volume of medical service. The causes for the rise include both iatrogenic and non iatrogenic ones. The paper puts forward 6 countermeasures.
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To establish a practical compensation model for medical accident,the total sum allowed must firstly be prescribed.The sum may be calculted similar to but smaller than that paid for traffic ac- cident.Not all victims of medical accident are entitled to receive the prescribed sum.The sum actually of- fered is determined by three factors.①the weight of the causes (the intensity of the fault);②the de- gree of working capacity loss brought about by the aftereffect of an accident;③the factor of age.As the grades of these three factors are respectively assessed,the compensation aum may be worked out.
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Distinguish between the medical accident and the medical malpractice and the definitude of their responsibility, are propitious to solve and mitigate the conflict between the doctors and the patients. The text compares the medical accident with the medical malpractice, from their definition, elements and respond.