摘要
目的:冠状动脉旁路移植术是国家卫生健康委重点监测的手术之一,医疗纠纷案例中普遍存在对患者的非预期伤害,对纠纷案例中医疗过失和患者损害的深入分析和总结可以为临床医生规范日常诊疗行为提供参考,有利于促进该手术医疗质量的提高。方法:对中国裁判文书网公布2012-2020年94份“冠状动脉旁路移植术”纠纷案例判决书进行案例特征提取,使用描述性统计分析案例基本特点、损害结果及赔偿特点,知识图谱和词云图对纠纷案例包含的医疗过失进行可视化呈现。结果:冠状动脉旁路移植术纠纷案例平均责任比例为31%,平均赔偿金额235520元;不同并发症对应的平均住院日、责任赔偿比例和术后生存天数不同。冠状动脉旁路移植术纠纷案例知识图谱可查询同类案例的常见医疗过失,影响因素和发生路径。结论:冠状动脉旁路移植术纠纷案例院方平均责任比例和赔偿金额较高,需加强对该手术医疗质量安全问题的定量和可视化分析,辅助医疗质量持续改进。
Objective:Coronary artery bypass grafting(CABG)is one of the important operations monitored by the national health commission.The in-depth analysis of medical malpractices and patient harm in dispute cases can provide reference for clinicians to standardize their daily diagnosis and treatment behavior,which is conducive to improving the medical quality of the CABG.Methods:94 cases of"coronary artery bypass grafting"disputes published on the Chinese judicial documents network from 2012 to 2020 were included,and the damage results and compensation characteristics of the cases were analyzed by descriptive statistics.The knowledge graph and word cloud map were used to visualize the medical malpractices included in the dispute cases.Results:The average liability ratio of CABG disputes was 31%,and the average compensation was 235520 yuan.The average length of stay,proportion of responsibility and postoperative survival days were different for different surgical complications.The knowledge graph of CABG dispute cases could be used to query the common medical malpractices,influencing factors and evolution paths of similar cases.Conclusion:The average liability ratio and compensation amount of disputes cases related to coronary artery bypass grafting are relatively high,and it's necessary to strengthen the analysis of the medical quality and safety issues of this surgery to assist in continuous improvement of medical quality.
作者
陈洁
王博冉
王晶桐
CHEN Jie(Department of Medical Quality Management,Peking University People's Hospital,Beijing,100044,China)
出处
《医学与社会》
北大核心
2023年第6期106-111,118,共7页
Medicine and Society
基金
北京大学人民医院研究与发展基金资助课题,编号为RDM2021-01
国家自然科学基金资助项目,编号为72004147。
