- 期刊
臺北市醫療爭議解決途徑之分析
Analysis of Medical Dispute Resolution in Taipei City
摘要
目的：90-94年間衛生局共接獲醫療爭議案件889件，其中低於兩成申請醫療爭議調處。本研究旨在分析台北市醫療爭議調處及司法訴訟之案件型態，以供政策制定者及醫界參考。方法：本研究為回溯性的縱向次級資料分析，資料來源係民國90-94年台北市政府衛生局之調處資料庫及司法院裁判書資料庫。結果：調處案件發生原因以醫療直接相關者最多佔86.1%，科別依序為內科(30.1%)、婦產科(24.5%)、外科及整型外科（各9.6%）。此外依87-89年間臺北及士林地方法院受理之醫療爭議案件，分析一審及二審的上訴率，民事訴訟分別為22.2%及0%；而刑事訴訟則為44.1%及26.7%。結論：目前調處之利用率及成功率都不高，訴訟方面病家能堅持上訴或是勝訴的機率也不高，未來如何擴大醫病雙方對調處的接受度，可能是降低醫療爭議傷害的一個重要課題。
並列摘要
Objectives: Within 2001-2005, Taipei City Government Department of Health (TCGDOH) received 889 medical dispute complaints, of which 166 filed for their mediation. This study aims at analyzing the patterns of mediation operated by the health authorities and litigation in Taipei city. Methods: This study is a retrospective longitudinal secondary data analyses. The data came from the mediation data base of the TCGDOH and the court judgment database of the Judicial Yuan within 2001-2005. Results: Of the mediation cases, 86.1% are directly medical related in terms of causes; 30.1% concern the specialty of internal medicine, 24.5% obstetrics and gynecology, 9.6% surgery and 9.6% plastic surgery respectively. Analyzing the court cases transpired between 1998 and 2000, of those filed in the civil docket, 22.2% appealed the district courts' decisions and none appealed the appellate court's decisions; whereas in the criminal docket, 44.1% went on to the appellate court and 26.7% to the supreme court. Conclusions: Both the utilization rate and success rate of TCGDOH mediation are not high. On the other hand, most patients and their families cannot persist through the appellate process and their chances of winning are also low. Increase the general public's acceptance of administrative mediation could potentially create an important avenue to mitigate the damage caused by medical disputes.