Seguro de responsabilidade civil médica não garante segurança do paciente / Medical liability insurance does not guarantee patient safety

O presente ar tigo, pautado no método hipotético-dedutivo, tratou do seguro de responsabilidade civil médica no Brasil diante do aumento das ações judiciais relacionadas à saúde. A partir de uma pesquisa com abordagem qualitativa e utilização de procedimentos bibliográficos e documentais, objetivou-se descobrir se a contratação de seguros profissionais teria um possível efeito preventivo de proteção ao médico e ao paciente contra danos durante a assistência. Para tanto, apresentaram-se noções introdutórias sobre esse tipo de seguro e os principais desafios contemporâneos relacionados a sua utilização para, finalmente, se avaliarem as prováveis consequências dele frente às ações indenizatórias. Verificou-se que a contratação do seguro de responsabilidade civil médica ainda não alcançou números expressivos no país, e que a inexistência de imposição legislativa e a ausência de incentivo pelo conselho profissional competente podem ser fatores que contribuem para esse cenário. Com desafios pré-existentes semelhantes, a experiência nos Estados Unidos demonstrou efeito contrário à prevenção, com o crescimento de ações indenizatórias e o surgimento de uma nova crise. Por fim, os resultados apontaram para a solidificação da segurança do paciente em detrimento das adversidades decorrentes da adesão ao seguro.

The present article, based on the hypotheticaldeductive method, dealt with medical liability insurance in Brazil in view of the increase in health-related lawsuits. From a research with a qualitative approach and the use of bibliographic and documental procedures, the objective was to discover whether the contracting of professional insurance would have a possible preventive effect of protecting the doctor and the patient against damages during care. To do so, introductory notions about this type of insurance and the main contemporary challenges related to its use were presented, and finally, the probable consequences of this type of insurance Against indemnity claims were evaluated. It was verified that the contracting of medical liability insurance has not yet reached expressive numbers in the country, and that the inexistence of legislative imposition and the absence of incentive by the competent professional council may be factors that contribute to this scenario. With similar pre-existing challenges, the experience in the United States has demonstrated the opposite effect to prevention, with the growth of indemnity suits and the emergence of a new crisis. Finally, the results pointed to the solidification of patient safety at the expense of the adversities arising from insurance adherence.

Practical experience of medical liability insurance and third-party mediation mechanism at Heilongjiang Provincial Hospital / 中华医院管理杂志

Heilongjiang Provincial Hospital has scored an initial success in dealing with medical disputes since the medical liability insurance and third-party mediation mechanism were introduced into the hospital in 2013.The paper identified problems found in the practice,and recommended the following:rationalizing the cost of insurance coverage,expanding scope of third-party mediation properly,enhancing professional authority in assessment of medical dispute cases,simplifying insurance compensation procedure,and consolidating the legal status of the medical dispute mediation institutions,for better resolution of such disputes.

Investigation on the awareness and demand for medical liability insurance of doctors：Case study of a top 3 general hospital in Guangzhou / 中国卫生政策研究

Objective:This paper aims to investigate the awareness and demand for medical liability insurance of doctors, and to provide policy recommendations for the further development of medical liability insurance in China. Method:A stratified random sampling survey is conducted on doctors from a Top3 general hospital in Guangzhou, and the relevant departments and individual doctors were interviewed. Results:The higher the risk in a department, the higher their awareness of medical liability insurance becomes;the longer the length of service for a doctor, the more understanding of medical liability insurance the doctor has. Medical liability insurance is generally supported by doc-tors with a strong willingness of demand, but they opinions on bearing and sharing the insurance premium are quite different. Discussion:Doctors still lack sufficient knowledge of medical liability insurance due to the lack of effective publicity. The structural mode of medical liability insurance is still relatively vague, and the government leadership and market operation ability have a serious shortage. Suggestion:This paper suggest to improve the relevant laws and regulations of medical liability insurance, to strengthen government supervision and publicity, to build a reasonable development model of medical liability insurance in line with the national circumstances, and to strengthen an effec-tive combination of government leadership and market operation.

Thoughts on practice of medical liability insurance at the hospital / 中华医院管理杂志

An analysis of medical liability insurance practice at the hospital in the past 6 years found that medical liability insurance failed to work as expected in medical dispute prevention and risk sharing.The analysis also found that such an insurance will take a greater role in risk sharing,exposure to conflicts,cause discovery,and responsibility,with enhanced government role in guidance and intervention.Thus medical liability insurance is highly advocated by such means as compulsory execution,coordinating mechanism of insurance funding,prevention“medical dispute profiteers”,and adaptation to new approaches in medical dispute settlement.

An empirical study of medical liability insurance in Nanjing / 中华医院管理杂志

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.

Mechanism of the medical dispute handling mechanism and its effects in Ningbo / 中华医院管理杂志

"The Provisional Regulations for Prevention and Handling of Medical Disputes in Ningbo" was issued as one of the mayor's instructions. This document advocates such principles as prevention priority, lawful handling, fairness, convenience and people oriented. Ningbo called into play a third party, the insurance claims settlement mechanism, and people's medication mechanism, which facilitated the 4-party cooperation and enriched means for dispute handling. A year of practice proved these efforts as successful in solving disputes, easing doctor-patient conflicts, improving doctor-patient relationship, avoiding loss of state-owned assets, as well as upgrading hospital management and quality of care of the hospitals.

Discussion of medical liability insurance / 中华医院管理杂志

Setting up and improving the system of medical liability insurance is the primary direction in and the chief means of dispersing medical risks and settling medical disputes. However, the system currently in use in China is confronted with a number of problems, including, on the theoretical plane, insufficient effective demand by medical institutions, varied understanding of the insurance-covered services by the parties involved, different expected values with regard to the final results of the insurance, and on an operational plane, the legal positioning of the disposition of medical disputes, the relationship between the rights and obligations of the parties involved during dispositions or lawsuits, the comprehension and explanation of certain provisions of the insurance and so on. In order to solve these problems, it is necessary to take such measures as setting up a mechanism for negotiations in the trial period of medical liability insurance, opening up insurance market, implementing the separation of medical administrative liabilities and civil compensation liabilities, and encouraging patients to buy medical risk insurance while developing medical liability insurance The goal is to improve the system of medical liability insurance, harmonize the relation between doctors and patients, and thus build a harmonious society.

On Effective Approaches of Medical Liability Insurance to Relieving Physician-Patient Conflicts / 中国医学伦理学

A fair,just,and credible mediation institution is required to ensure the effective implementation of medical liability insurance,relieve physician-patient conflicts,and protect the legal rights of medical institutions,patients and insurance corporations as well.Medical disputes mediation institution,as the arbitrator of physician-patient conflicts,clarifies the rights and obligations on all parties,including doctors,patients,and the insurance corporations as well,safeguards the legal rights of all parties,standardizes and simplifies the settlement procedure of medical disputes,and provides an effective approach to relieving the conflicts between doctors and patients.

On the Role of Medical Liability Insurance on Relieving Physician-Patient Conflict / 中国医学伦理学

Based on the realistic circumstances at home and successful experiences from abroad,this paper holds the idea to introduce medical liability insurance into medical market to relieve the currently tense physician-patient conflict and analyzes the role and function of medical liability insurance.Meanwhile,some problems and countermeasures are also explained in the functioning process of medical liability insurance.