School of Government, Sun Yat-sen University, Guangzhou, China.
Center for Chinese Public Administration Research, School of Government, Sun Yat-sen University, Building 507, No. 135 Xingang west road, HaiZhu district, Guangzhou, China.
Int J Legal Med. 2021 May;135(3):1047-1054. doi: 10.1007/s00414-020-02386-x. Epub 2020 Aug 12.
Medical malpractice litigations affect the practices of patient safety. However, medical malpractice litigations involve highly specialized knowledge. Thus, medical appraisal is usually essential in the ascertainment of responsibility and judicial decision-making. China's judicial system is characterized by a dual-mode of medical appraisal resulting from two parallel appraisal agencies: judicial appraisal institutions and medical associations. This paper examines whether or not and how choices of different medical appraisal agencies affect malpractice lawsuit results in China.
We collected and sampled a total of 2557 verdicts pertaining to medical disputes from "China Judgements Online" in 2014. We used an ordinary least square regression model and a mediating effect regression model to analyze to what extent and how different choices between two medical appraisal agencies affect malpractice litigations.
(1) Almost 81.55% (2082) of litigants resorted to medical malpractice appraisals in China in 2014. Among 2070 cases with appraisal results accepted by the court, 60.10% of the litigants chose judicial appraisal institutions (1244), as opposed to medical associations (826). (2) Among 2557 cases, 2306 (90.18%) claimed compensation and 1919 (83.22%) were awarded compensation by the courts. The proportion of compensation paid in a case is 48% on average. (3) Appraisal agencies matter in the investigation of medical errors, which in turn affects the proportion of compensation paid in a case. (4) Choosing judicial appraisal institutions will raise the proportion of compensation paid by about 10% on average.
Different choices between appraisal institutions affect malpractice litigations in China. As the last resort for remedying medical malpractice, medical appraisals in the judicial system could be a source of inequality in China's medical litigation outcomes.
医疗事故诉讼影响患者安全实践。然而，医疗事故诉讼涉及高度专业化的知识。因此，医疗鉴定通常是确定责任和司法决策的必要手段。中国的司法制度的特点是双重模式的医疗鉴定，由两个平行的鉴定机构：司法鉴定机构和医学会。本文考察了不同的医疗鉴定机构的选择是否以及如何影响中国的医疗纠纷诉讼结果。
我们从 2014 年的“中国裁判文书网”上共收集了 2557 份与医疗纠纷相关的判决，并使用普通最小二乘法回归模型和中介效应回归模型分析了不同的医疗鉴定机构选择在多大程度上以及如何影响医疗纠纷诉讼。
（1）2014 年，中国近 81.55%（2082 例）的诉讼者诉诸医疗事故鉴定。在 2070 例有法院接受的鉴定结果的案件中，60.10%（1244 例）的诉讼者选择了司法鉴定机构，而不是医学会（826 例）。（2）在 2557 例案件中，2306 例（90.18%）要求赔偿，1919 例（83.22%）被法院判给赔偿。案件中赔偿支付的平均比例为 48%。（3）鉴定机构在医疗差错调查中起作用，这反过来又影响案件中赔偿支付的比例。（4）选择司法鉴定机构将使案件中赔偿支付的比例平均提高约 10%。
不同的鉴定机构选择影响中国的医疗纠纷诉讼。作为医疗事故的最后补救手段，司法体系中的医疗鉴定可能是中国医疗诉讼结果不平等的一个来源。
