Objective To understand the cognition and mediation tendencies of health care workers in terms of third-party mediation for medical disputes, analyze the factors influencing the trust of both doctors and patients on third-party mediation, and propose suggestions on building third-party mediation mechanisms for medical disputes.
Methods Between August and December 2012, we made the cognition questionnaire on third-party mediation for medical disputes based on the past medical literature, and the knowledge of doctor-patient relationship as well as third-party mediation agency's organizational structure (including locations and management authorities), staffing, mediation basis, validity sources and fund ensuring. We performed the random cluster sampling survey on all health care workers in five hospitals of different levels. The original data were put into the computer for statistical analysis by SPSS 18.0.
Results The knowledge of health care workers on third-party mediation was high. They believed that the best place for solving medical disputes should be the court or judicial administrative department, and the management authorities should be health administrative departments. In case of mediation failure, the majority of health care staff chose to continue to solve the dispute through legal channels. For the effectiveness of mediation conclusion, most health care workers tended to believe in the form of arbitration. They thought that mediators should have professional background of medicine and law; the majority of those surveyed doctors tended to accept forensic conclusions as a basis for mediation. For determining the compensation, doctors were in favor of Applicable Regulations for Medical Malpractice. Over 40% of medical staff believed that third-party mediation should be financed by government financial allocation, and more than half of the medical staff believed that it should be paid by the insurance company.
Conclusion Third-party mediation should be set in and managed by the court or judicial and administrative departments. Mediator group should be formed by professionals of law and medical sciences. In the mediation process, it is recommended that the focus of controversy should be identified by forensic identification in order to form a clear division of responsibilities and high mediation efficiency. We recommend that the government introduce in financial allocations at all levels on the basis of medical liability insurance system, and force medical institutions to purchase medical liability insurance through the regulations of law, in order to provide funding support for the operation of third-party mediation organizations. Meanwhile, medical liability insurance companies should be operated under strict supervision to avoid their interference on the mediation work.
Citation:
XIAYong-jun, LIUKe, DONGHe-wen, ZENGDa, LIUMin. The Survey on Third-party Mediation Model for Medical Disputes. West China Medical Journal, 2015, 30(8): 1552-1558. doi: 10.7507/1002-0179.20150447
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Copyright © the editorial department of West China Medical Journal of West China Medical Publisher. All rights reserved
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- 1. 梁治平. 寻求自然秩序中的和谐[M]. 北京:商务印书馆, 2013:203.
- 2. 梁华仁. 医疗事故的认定与法律处理[M]. 北京:法律出版社, 1998.
- 3. 曹庆华, 邓世雄, 陈丽娜. 医疗纠纷诉讼程序与非诉讼程序的效益对比分析[J]. 医学与哲学, 2010, 31(9):28-29, 39.
- 4. 刘耿. 医患纠纷:第三方转正[J]. 瞭望东方周刊, 2011(39):35-39.
- 5. 文贻军. 各国医疗纠纷ADR模式比较[J]. 实用预防医学, 2010, 17(12):2550-2552.
- 6. 陈贤新, 张泽洪. 国内外医疗纠纷第三方调解机制述评[J]. 中国医院, 2010, 14(5):43-45.
- 7. 张锦玉. 医疗纠纷影响医生对医患关系认识的调查分析[J]. 医学与哲学, 2010, 31(21):41-42.
- 8. 相海泉. 人民调解委员会的艰苦生存[J]. 当代医学, 2008(增刊1):26-29.
- 9. 孙小丽, 郭秀琴, 陈文举, 等. 医生医疗法规认知及医患纠纷调查分析[J]. 医学理论与实践, 2012, 25(9):1033-1036, 1044.
- 10. 赵存喜. 评《侵权责任法》中的医疗损害责任[J]. 中国司法鉴定, 2010, 49(2):45-47.
- 11. 代号, 孙小丽, 夏勇军, 等. 患者对侵权责任法的认知及医患关系调查分析[J]. 华西医学, 2014(9):1765-1769.
- 12. 刘士国. 论医疗损害责任立法规定之问题与完善[J]. 江苏行政学院学报, 2009, 48(6):109-113.
- 13. 陈建波. 医疗纠纷司法鉴定的法律依据——兼谈正确处理司法鉴定与医疗事故鉴定的关系[J]. 法律与医学杂志, 2005, 12(3):204-206.
- 14. 陈美雅. 医疗纠纷诉讼外解决机制比较研究[J]. 法律与医学杂志, 2006, 13(3):181-190.
- 15. 郭进, 袁江帆. 论我国医疗责任险模式的完善与建设[J]. 解放军医院管理杂志, 2008, 15(1):21-22.