Li Yuan, Gao Dong, Liang Weibo, Qiu Lirong, Liu Xin, Zhang Lin, Deng Zhenhua
Department of Forensic Pathology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, PR China; Department of Forensic Genetics, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, PR China.
Key Laboratory of Forensic Medicine, Institute of Forensic Science, Ministry of Justice, No. 1347 West Guang Fu Road, Shanghai, 200063, PR China.
J Forensic Leg Med. 2018 Feb;54:109-113. doi: 10.1016/j.jflm.2018.01.002. Epub 2018 Jan 31.
An analysis of malpractice lawsuits judged in court compared with those mediated in court may help explain perceptions of malpractice risk.
We conducted a retrospective study of malpractice lawsuits mediated and judged in court using data from district courts in Beijing from 2010 through 2014. We evaluated the number of cases, the payment amount, and the time to resolution, by resolution type. Patient age, sex, the severity of injury, and adverse event type were measured. Subsequently, a binary logistic regression identified factors associated with patients' pursuit of judgment.
Between 2010 and 2014, there were 1226 lawsuits (49.9%) mediated in court and 1259 (50.1%) judged in court. The proportion of the judged lawsuits varied significantly across the study period (p < 0.001). The mean payment amount and the time to resolution were significantly higher in judgment lawsuits (p < 0.001). The younger the patients, the greater the possibility of being judged in court (odds ratio [OR] = 0.831, p < 0.0001). Lawsuits where the adverse event type was treatment, obstetrics, or diagnostics were more likely to be judged than those where the adverse event type was surgical (OR = 2.311, p < 0.0001; OR = 2.311, p < 0.0001; OR = 3.302, p < 0.0001, respectively). When lawsuits were for a temporary injury, they were more likely to be judged in court than those for a permanent injury (OR = 0.723, p = 0.0139).results CONCLUSIONS: The patient-physician relationship may in fact not be particularly close in our country. Lawsuits with certain characteristics tend to be judged in court. Understanding these characteristics may be useful for predicting the outcome of lawsuits against physicians.
对经法庭判决的医疗事故诉讼与经法庭调解的医疗事故诉讼进行分析，可能有助于解释对医疗事故风险的认知。
我们利用2010年至2014年北京地方法院的数据，对经法庭调解和判决的医疗事故诉讼进行了回顾性研究。我们按解决方式类型评估了案件数量、赔偿金额和解决时间。测量了患者的年龄、性别、损伤严重程度和不良事件类型。随后，进行二元逻辑回归分析以确定与患者寻求判决相关的因素。
2010年至2014年期间，有1226起诉讼（49.9%）经法庭调解，1259起（50.1%）经法庭判决。在整个研究期间，判决诉讼的比例差异显著（p<0.001）。判决诉讼的平均赔偿金额和解决时间显著更高（p<0.001）。患者年龄越小，经法庭判决的可能性越大（优势比[OR]=0.831，p<0.0001）。不良事件类型为治疗、产科或诊断的诉讼比不良事件类型为手术的诉讼更有可能被判决（OR分别为2.311，p<0.0001；OR为2.311，p<0.0001；OR为3.302，p<0.0001）。当诉讼涉及临时损伤时，与涉及永久损伤的诉讼相比，更有可能经法庭判决（OR=0.723，p=0.0139）。
在我国，医患关系实际上可能并非特别密切。具有某些特征的诉讼往往会经法庭判决。了解这些特征可能有助于预测针对医生的诉讼结果。
