Study On The Current Situation And Countermeasures Of Medical Liability Insurance In Nanjing

Objective Through retrospective analysis of contract and claim data of medical liability insurance in Nanjing,this study compares the operation experience of medical liability insurance at home and abroad,explores the influencing factors of medical risk and the impact of key issues of healthy operation of medical liability insurance on medical liability insurance in Nanjing,and finds out the influencing factors of medical liability insurance.The key factors of healthy operation provide reference for improving the design of insurance products,the way of insurance claims and the prevention of medical risks,and put forward feasible suggestions for the operation of medical liability insurance in Nanjing,so as to provide regional experience for the healthy development of domestic medical liability insurance.Material and methods Through consulting the business system of the insurance company,the data of insurance and claim list of Nanjing Medical Liability Insurance from April 2017 to October 2018 were collected and collected.SPSS 22.0 analysis software was used to analyze the factors affecting the premium coefficient,such as the number of inpatients,outpatients and surgical cases in the secondary and tertiary medical institutions insured continuously for 2two years from 2017 to 2018.χ-test and logistic regression of single and multiple factors were used to classify the compensation cases.Risk factors such as hospital grade,hospital type,hospitalization,operation,responsibility and Department distribution were analyzed.ResultsThrough the study of the medical liability insurance clauses in Nanjing,it was found that the risk factors affecting the premium were the number of patients,the number of hospitalized persons,the number of surgeons,the grade of medical institutions,the type of medical institutions,the amount of insurance and the retrospective period.Through comparative study,it was found that the risk factors of the current premium calculation in Nanjing were more complicated and detailed than before,and the premium rate could be determined more accurately to ensure fairness and scientificity.In this study,single-factor logistic regression analysis of medical risks in different departments of medical disputes compensation cases was conducted.Obstetrics,gynecology,orthopaedics,respiratory medicine,urology,general surgery,neurology,digestive medicine,cardiology,thoracic surgery and other departments had higher medical risks.In this study,the types of medical institutions and the classification of compensation cases were examined by χ2-test between groups,which showed that the medical risks of different types of medical institutions were different,and the risks of general hospitals and traditional Chinese medicine hospitals were higher.The results were basically consistent with those of this study,which showed that the current calculation of medical liability insurance in Nanjing was more reasonable.However,it was also found that the calculation of risk factors in traditional Chinese medicine hospitals was inaccurate and should be treated as an appropriate adjustment of general hospitals.In this study,the risk factors and the basic premium coefficients of the second and third-level medical institutions insured for two consecutive years were analyzed by t-test.The value of p > 0.05,indicating that there was no difference in medical risks between the second and third-level medical institutions,but the incidence of major claimed in the third-level medical institutions was significantly higher than that in the second-level medical institutions.In the analysis of medical disputes claims cases,it was found that the compensation rate of secondary medical institutions was significantly higher than that of tertiary and tertiary medical institutions,indicating that insufficient estimation was made of the medical risks insured by secondary medical institutions.In this study,the compensation cases were classified according to the amount of damage,and the risk factors of different medical risk 2factors were examined byχ-test and multivariate logistic regression analysis.It wasfound that the risk factors such as the grade of medical institutions,the type of medical institutions and whether hospitalization or not were the important basis for premium calculation.In this study,we also found that there was no difference in the medical risk of operation in case amount classification,which indicated that it was not a risk factor of case classification and major medical disputes,and that the number of operation cases could not be included in the premium calculation factor.In this study,only 6 of 296 compensation cases entered the court proceedings,with the mediation rate of hospital mediation and medical mediation reaching 98%.It showed that it was reasonable to establish a mediation center for medical liability insurance claimed settlement in Nanjing,which alleviated the contradiction between doctors and patients.Conclusion1.Nanjing Medical Liability Insurance has formed a regional operating mode,including the government-led mode,which forces public hospitals to form a co-insurance body.Through product innovation,the premium factors and insurance products are constantly enriched.Through the establishment of medical mediation committee,the mode of case mediation is strengthened to promote the healthy development of medical liability insurance.Exhibition plays an important role in social stability.2.Hospitals should abandon traditional concepts,make full use of insurance concepts,establish a new medical risk management mechanism,establish a risk management model for medical institutions and medical personnel,and truly resolve medical risks.3.Insurance companies should constantly innovate insurance products,operate in various ways,introduce professional and technical personnel,provide scientific insurance products for medical institutions,play an important role in medical disputes,deal with medical disputes fairly and fairly,and truly play the role of social stabilizer of insurance.4.The government should give full play to the role of administrative management,give guidance in policy,give preferential treatment in cost and support in big data of medical insurance,so as to make medical liability insurance scientifically determine rates,reduce operating costs,improve operational efficiency and ensure its healthy development.5.The role of medical liability insurance in resolving medical disputes and stabilizing social and economic development needs further consideration and improvement of legislation and establishment of special laws to regulate the operation of medical liability insurance.