Analysis Of Influencing Factors Of Medical Disputes In A Tertiary A Hospital In Jilin Province

Objective: This study investigated the cases of medical disputes in a third-class A hospital in Jilin Province in recent five years,and analyzed the influencing factors of medical disputes in the hospital,so as to provide reference for further prevention of medical disputes,strengthening medical quality and safety management,improving doctor-patient relationship and formulating prevention and control measures of medical disputes.Methods: In this study,medical dispute cases and their corresponding medical record information occurred from January 1,2016 to December 31,2020 were used as data sources.Literature research method was used to sort out relevant literature on medical dispute,determine the research plan,and find out the influencing factors of medical dispute indicators.324 valid cases were obtained through retrospective study.The medical parties and patients of medical disputes were taken as the research objects,and the basic information of the medical parties,patients and diagnosis and treatment were respectively descriptive analyzed.From inpatients cases,according to the proportion to find matching the dispute of medical record for comparison,under the different variables(such as medical payment method,surgery,hospitalization days and the situation of hospital,medical costs,etc.)whether medical disputes occurred in single factor analysis,on the basis of single factor analysis,using Logistic regression analysis on the factors of medical disputes.Results:1.Doctors with 20-30 years of service had a 3.005 times higher risk of disputes than those with 0-5 years of service,and doctors with more than 30 years had a 4.836 times higher risk of disputes than those with 0-5 years of service.2.The risk of disputes in patients who need surgery after admission is 3.217 times higher than that who do not need surgery.3.The risk of disputes for patients with medical expenses greater than 20,000 yuan is 3.005 times that for patients with medical expenses less than or equal to 20,000 yuan.4.The risk of disputes among patients who need emergency treatment after admission is 2.191 times that of patients who do not need emergency treatment.5.The risk of disputes for patients who need to be transferred after admission is 4.628 times that of patients who do not need to be transferred.6.The risk of disputes among patients who need consultation after admission is3.110 times that of patients who do not need consultation.7.The risk of disputes in patients with uncured disease at discharge was 2.693 times that of cured patients,and the risk of disputes in patients with death was 6.780 times that of cured patients.8.The risk of disputes in patients with drug allergy was 1.419 times higher than that in patients without allergy.9.The risk of disputes in patients who are not informed of special examination is 5.073 times that of those who are informed.10.The risk of dispute in patients with missing alternative treatment plan was 5.239 times higher than that in patients without missing alternative treatment plan.11.The risk of disputes in critically ill patients during hospitalization was4.823 times higher than that in non-critically ill patients.12.The risk of disputes during hospitalization in critically ill patients is 6.160 times higher than that in non-critically ill patients.Conclusion:1.The reasons of medical institutions account for a large proportion,and diagnosis and treatment problems account for the largest proportion in medical disputes.Medical disputes are more likely to occur in cases of department transfer,consultation,uninformed special examination,lack of alternative diagnosis and treatment schemes,etc.2.The working years and professional titles of doctors are the main factors affecting medical disputes.3.Patients’ high expectation of diagnosis and treatment results has a high impact on the occurrence of medical disputes.Patients have a high probability of medical disputes when they are critically ill or critically ill during hospitalization,when they undergo surgery,rescue treatment,when they are discharged unrecovered and when they die.