醫療糾紛預防機制及調處成功因素之研究-以台中縣市為例

Study on The Medical Malpractice dispute prevents a mechanism and Key Successful Factors for Mediate Medical Dispute in Taichung Area

楊修銘(Yang Xiu Ming)

指導教授 ： 楊志良

亞洲大學/健康學院/健康產業管理學系健康管理組/碩士(2012年)

摘要

在深入研討各醫療爭議調處等相關資訊後，本研究藉由醫療糾紛處理經驗的醫事人員，探討目前台灣醫療爭議事件的現況與調處制度實踐困境；另一方面，藉由資料性研究成果，解析台中縣市醫療糾紛之病患、調解者、醫療院所對醫療糾紛調解之重要因素，建構讓醫病雙方滿意且信任的醫療爭議處理制度為本研究欲探討之重點。 研究結果顯示：（1）從病患及其家屬的訪談資料中發現，「要求認錯」是病患及其家屬處理醫療糾紛經驗的核心概念。在調處案件性質上，則多透過自行私下和解方式解決並給予病患及其家屬金錢上的補償；（2）在可能引起醫療糾紛發生的因素的探討中，可以歸納出醫療糾紛發生可能的因素大致可以分為兩類：一為醫病關係的良好與否，二為醫事人員與病患及其家屬在整體醫療服務過程中所產生認知的差距，導致病患對於醫療服務結果不滿意，對醫事人員抱怨，當對抱怨處理不當，即進一步演變為醫療糾紛。因此，要預防醫療糾紛的發生，大致可以從這兩方面從手，以達到真正預防的目的；（3）醫療糾紛調處以未進入調處單位階段最重要、進入調處階段以醫病雙方態度最重要、調處不成立後階段以對病患的影響最大；（4）以整體樣本而言，影響調處成敗的關鍵因素透過訪談整理及統計資料分別得知以下結論：經營良好醫病互動關係才可能使醫師道歉時較容易成功且協調和調解機制也較容易成立，另調處的金額是調處成立的最關鍵因素。

關鍵字

醫病關係 ； 醫療糾紛 ； 調處

並列摘要

After being going deep into to study and discuss each medical treatment controversy to adjust to wait for related information, this research by medical treatment dispute processing curing of experience matter personnel, inquire into currently a Taiwanese medical treatment to dispute affairs of current conditions with adjust a system fulfillment dilemma;Study a result and analyze the patient, peacemaker and medical institution's important factor to the intermediation of the medical treatment dispute of county City medical treatment dispute in Taichung by the data on the other hand, the construction lets to cure illness the medical treatment controversy processing system of both parties' satisfaction and trust to want to inquire into for this research of point.
Results of this study shows：(1)From the interviews of patients and their families found,「request to admit mistake」is the core concept of patient and dispute experience of the processing medical treatment of its family members. In adjusting a case property, many then through by oneself and privately reach agreement a way to solve and give the repair of patient and money of its family members; (2)In the possibility cause the study of factor of the occurrence of the medical treatment dispute, canning induce medical treatment dispute to take place a possible factor mostly can be divided into two types:One for cure illness to relate to of good or not, two for cure a matter the personnel and patient and its family members is in whole process of the medical treatment service the margin of cognition produced, cause the patient serve a result to be dissatisfied with to the medical treatment, not be handled properly towards curing the matter personnel's complaint, being to the complaint, then turn into into medical treatment dispute further.Consequently, prevent the occurrence of medical treatment dispute, mostly can from this both side from the hand with reach the purpose of real prevention; (3)For mediation of medical dispute, it comes as the most important one when the Mediation Unit does not get involved in the mediation yet; attitude between medical institute and patient during the stage when Mediation Unit gets involved in the mediation of medical dispute is the most critical factor; it has the most critical affect on patient as it comes in the stage when the mediation is failed; (4)In the context of the entire samples, The influence adjusts the key factor of a success or failure to tidy up and statistics data to know respectively through the interview to draw a conclusion: Conduct good cure illness an interactive relation just may make the doctor apologize a little bit easily succeed and coordination and intermediation mechanism also a little bit easily establish, and The amount of money that adjusts is to adjust to establish most a key factor.

並列關鍵字

doctor-patient relationship ； Medical Dispute ； Mediation

參考文獻

黃富源、李明濱，台灣醫界‐醫學倫理品質繼續教育專欄，Vol.52，No.2，2009。

何日生，人醫心傳-談醫療糾紛，頁9，2005。

何日生，談醫療糾紛。人醫心傳社論，頁8-9，2005。

林東龍，醫療糾紛之社會控制：社會學的分析，國立中山大學中山學術研究所碩士論文，2003。

楊秀儀，瑞典「病患賠償保險」制度之研究-對台灣醫療傷害責任制度之啟發，台大法學論叢，30（4），2000。