Chia Wen-Chun, Chen Li-Sheng, Wang Sen-Te
Department of Family Medicine, Taipei Medical University Hospital, Taipei 110, Taiwan.
School of Oral Hygiene, College of Oral Medicine, Taipei Medical University, Taipei 110, Taiwan.
Healthcare (Basel). 2023 Jul 25;11(15):2121. doi: 10.3390/healthcare11152121.
(1) Background: Medical disputes have long been resolved via lawsuits. Alternative dispute resolutions have been promoted for their benefits and win-win results. This study aims to investigate Taiwanese hospital medical dispute capacities and burdens. (2) Methods: This study used 2015 nationwide questionnaire data. The number and value of medical disputes that occurred in 2014 was examined to evaluate hospitals' capabilities. Poisson regressions were used to determine the impact of coping abilities on the incidence of disputes and the associated compensation. (3) Results: The response rate of the questionnaire was 90%. Hospital features associated with higher medical disputes incidence included those of a scale ≤ 100 or 200-499 and having a dispute-inform process of over 4 h. In contrast, hospitals whose compensation fund was solely based on medical liability insurance reported less medical dispute incidence. The features associated with higher compensation were lack of continuing training and having a dispute-inform process over 4 h. In contrast, hospitals with standard operating procedures for in-hospital mediation and solicitude paid lower compensation. (4) Conclusions: Hospitals with quicker response times experienced fewer medical disputes and paid lower compensation. Dispute coping skills, other than reaction time, were more visible in compensation bargaining, but were not significantly correlated with incidence.
(1) 背景：长期以来，医疗纠纷一直通过诉讼解决。替代性纠纷解决方式因其益处和双赢结果而得到推广。本研究旨在调查台湾地区医院处理医疗纠纷的能力和负担。(2) 方法：本研究使用了2015年全国性问卷调查数据。通过考察2014年发生的医疗纠纷数量和价值来评估医院的能力。采用泊松回归分析来确定应对能力对纠纷发生率及相关赔偿的影响。(3) 结果：问卷回复率为90%。与较高医疗纠纷发生率相关的医院特征包括规模≤100或200 - 499，以及纠纷告知流程超过4小时。相比之下，赔偿基金仅基于医疗责任保险的医院报告的医疗纠纷发生率较低。与较高赔偿相关的特征是缺乏持续培训以及纠纷告知流程超过4小时。相比之下，具有院内调解标准操作程序和关怀措施的医院支付的赔偿较低。(4) 结论：响应时间较快的医院经历的医疗纠纷较少，支付的赔偿也较低。除反应时间外，纠纷应对技巧在赔偿谈判中更为明显，但与纠纷发生率无显著相关性。
