Construction Of The Key Elements System Of No-Fault Compensation For Medical Injuries

ObjectiveLearning the advanced experience of “no-fault compensation system for medical injuries” from some classical countries,and combining with the realities in China,to build a system of no-fault compensation for medical injuries with Chinese characteristics,and to provide theoretical support and policy recommendations in a range of research and pilot work.MethodsOn the basis of literature reviews and translations of related questionnaire,with the methods of focus group discussion and brain storms,and together with the experts' suggestions,we formed the expert consultation questionnaire.Choosing 30 experts from health administration,universities,hospitals,legal field to make two rounds expert consultations,and construct the frame of no-fault compensation system.On the basis of this frame,we designed the key factors of this system.And we use the Epidata3.1 to build database and use SPSS 22.0 to analyze the data.Results1.The basic situations of expert consultation: this study chose 30 experts in the relevant area to consult,the number of experts who had the master degree or above were 26(86.7%),and who had a senior title of professional were 20(66.7%);the degrees of authority of the experts were greater than 0.7,about the importance and feasibility of elements,cooperation coefficients of two rounds of expert consultation were respectively 0.158,0.069 and 0.523,0.508,the chi-square results of cooperation coefficients all had statistically significance(P<0.05).2.Stakeholder analysis of no-fault compensation system for medical injuries: after two rounds of expert consultation,we selected 8 stakeholders;this research divided these stakeholders into 3 categories : the key stakeholders ? the close stakeholders and the edge of stakeholders respectively.The key stakeholders included doctors and patients;the close stakeholders included the government,the judicial testimony institution,health administration,expert group,insurance industry;the edge of stakeholders included news media.3.The key elements system of no-fault compensation for medical injuries: after two rounds of expert consultation,we formed the frame of no-fault compensation system for medical injuries,this frame included 5 first-degree elements and 18 second-degree elements,the first-degree elements included administrative system,financing mechanism,appraisal mechanism,compensation mechanism,litigation mechanism,and these elements covered all segments of compensation for medical injuries.We conducted the third round structured interview to consult the experts,aimed at analyzing and designing the elements of system frame,formed the no-fault compensation institutionalkey elements system for medical injuries.Conclusions1.This research shows that no-fault compensation system for medical injuries could be used as the reform direction for improving the medical compensation systems in China.Introducing this system reasonably and legitimately could compensate the patients immediately,and make doctors getting rid of the heavy lawsuits which can promote doctors to explore the medical technology.2.The government,the most powerful stakeholder,should play the leading part to coordinate the responsibilities and obligations of the stakeholders.3.No-fault compensation system can build a buffer zone to resolve the contradiction between doctors and patients fundamentally,and promote the development of doctor-patient relationship and health services.