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目的通过问卷调查的方式,针对医疗纠纷第三方调解模式,了解患者对其认知和选择倾向,分析患者对其信任程度的影响因素并提出促进其完善和发展的相关建议。方法 2013年11月-2014年4月参照既往有关文献资料,设计相关问题,制作《医疗纠纷第三方调解认知调查问卷》,对因伤病经住院治疗终结的患者进行整群随机抽样调查。将所得原始数据逐条录入计算机建立数据库,以SPSS 18.0软件对数据进行统计分析。结果共发放问卷500份,回收有效问卷486份。患者对第三方调解的知晓程度较高,知道者占61.52%。55.35%的患者认为调解应在法院进行并由法院主管;57.41%的患者选择在调解失败后通过司法途径继续解决纠纷;67.90%的患者倾向于以仲裁形式确认调解结论的效力。70.58%的患者认为调解人员应具备医学以及法学的专业背景,73.05%的患者倾向于采用司法鉴定的结论作为调解依据,此外,64.81%的患者倾向于适用《侵权责任法》作为确定赔偿的法律依据。53.70%的患者认为第三方调解应由财政拨款解决经费问题,38.48%的患者认为应由保险公司支付;同时,91.15%的患者认为医疗机构应该购买医疗责任险,且54.32%的患者认为保险公司不宜提前介入医疗纠纷的调解过程。结论应由政府财政拨款来保障第三方调解机构的经费,同时引入医疗责任险予以补充。医疗机构应购买医疗意外保险,解决无过失医疗损害引起的医疗纠纷的赔偿问题。第三方调解的调解地点应与法院或司法行政部门衔接,同时由法院或司法行政部门负责管理。调解员应由具备医学和法学知识的专业人员共同组成,并加强专业人才的培养、提高调解员的工作能力与服务水平。应选择医疗纠纷司法鉴定结论作为调解的依据,同时推动全国医疗纠纷仲裁制度的建立和发展。
Objective To investigate the third party mediation model of medical disputes by means of questionnaire and understand the patients ’cognition and choice tendency, analyze the influencing factors of patients’ trust and put forward some suggestions to promote their perfection and development. Methods From November 2013 to April 2014, we made relevant questionnaires and designed related questions to make a questionnaire about third-party mediation in medical disputes. We conducted a randomized, cluster-based survey of patients who were hospitalized due to injuries or injuries. The obtained raw data were entered into the computer one by one to establish a database, and SPSS 18.0 software was used to perform statistical analysis on the data. Results A total of 500 questionnaires were distributed and 486 valid questionnaires were collected. Patients were more aware of third-party mediation, accounting for 61.52%. 55.35% of the patients believed that the mediation should be carried out in the court and controlled by the court; 57.41% of the patients chose to continue to settle the dispute through judicial channels after the mediation failed; 67.9% of the patients tended to confirm the effectiveness of the mediation conclusion by arbitration. 70.58% of the patients think that mediators should have the professional background of medicine and law, 73.05% of the patients tend to use forensic conclusions as mediation basis, and 64.81% of patients tend to apply the Tort Liability Law as the law of compensation in accordance with. 53.70% of patients believe that third-party mediation should be funded by financial allocation to solve the funding problem, 38.48% of patients think it should be paid by insurance companies; the same time, 91.15% of patients think that medical institutions should purchase medical liability insurance, and 54.32% of patients think insurance companies Should not be involved in advance medical dispute mediation process. Conclusions Government funding should be used to protect the funding of third-party mediation agencies and at the same time to introduce medical liability insurance to supplement it. Medical institutions should purchase medical accident insurance to solve the problem of compensation for medical disputes caused by no-fault medical damage. The mediation of the third party shall be mediated by the court or the judicial administrative department and be managed by the court or the judicial administrative department. Mediators should be composed of professionals with medical and legal knowledge, and to strengthen the training of professionals to improve the mediator’s ability to work and service levels. The conclusion of forensic examination of medical disputes should be chosen as the basis for mediation and at the same time to promote the establishment and development of the medical arbitration system in the country.