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浙江桐庐试水医疗责任风险金 专家:属无奈之举--亲稳网络舆情监测室
2012-07-25

  据中国之声《新闻纵横》报道,如何减少医患关系中的不和谐因素,让医生安心诊疗,患者放心治病,一直是困扰着医疗机构的老大难问题。对此,浙江桐庐多家医疗机构一同设立了一种医疗责任风险金,试图通过这种方式缓解医患矛盾。这样究竟是一笔怎样的资金?这种抱团抗风险的方式能否达到预期的效果?

According to the sound of China《News and》report,How to reduce the doctor-patient relationship is not harmonious factors,Let the peace of mind of treatment,Patients heal rest assured,Has been bothering medical institutions long-standing problem。this,Zhejiang tonglu much home with medical institutions set up a medical liability FengXianJin,Trying to in this way better the contradiction。So what is a what kind of money?This kind of risk BaoTuan way and can achieve the desired effect?

  

17家医疗机构参与责任风险金 去年赔付总额逾127万元 17 home medical institutions involved in FengXianJin total compensation responsibility last year 1.27 million yuan

  去年11月,一位患者因咽痛发热到桐庐县中医院就诊,门诊医生诊断为“上呼吸道感染”,当天上午10点左右输完液后,患者没有任何不适,就自己回家了。没想到傍晚6点左右,患者却在家中不幸去世,家属无法理解,与院方产生纠纷。桐庐县中医院医务科科长李培泉说,经过尸检,患者其实是急性弥漫性肝坏死,他们能理解患者的离世对于家属的打击,但院方操作是规范的,这也让他们十分无奈。

Last November,For a patient with a sore throat fever to tonglu county hospital clinic,The doctor diagnosed outpatient service“Upper respiratory tract infection”,Ten o 'clock on the morning of the day lose my after fluid,Patients without any discomfort,His home。Didn't think about six o 'clock in the evening,But patients died in the home,Families can't understand,A dispute with the hospital。The tonglu county hospital YiWuKe section chief LiPeiQuan said,After autopsy,Patients with acute diffuse hepatic necrosis is actually,They can understand the patients from the blow for family members,But the hospital operation is standard,It also let them very helpless。

  李培泉:这是非常冤枉的事情。尸体解剖结果出来之后再去医疗事故鉴定,结果出来跟我们医院是没有关系的,她是其他原因引起的死亡。

LiPeiQuan:This is very wrong things。Autopsy results came to a medical accident after appraisal,The results come out with our hospital is not concern,She is other causes of death。

  在医患关系并不十分融洽的今天,面对这样的案例,医患双方往往各执一词,很难找到令双方都接受的解决方案。李培泉说,以前他们会各自找商业机构谈定一年的保险金额,发生这样的纠纷,由保险公司来赔偿。不过,桐庐县从去年1月1日开始推行医疗责任风险金,由桐庐县卫生局牵头,多家医疗机构按照一定的比例缴纳,并实行统一管理、统筹使用,李培泉说,相比起商业保险,这种方法操作上更加便捷,这个案例就是通过医疗风险金来解决的。

In the doctor-patient relationship is not very well today,In the face of such cases,Both doctors often argue,It is difficult to find make both sides accept solutions。LiPeiQuan said,Before they will each find business 谈定 a year of insurance amount,Had such disputes,The insurance company will compensate for。but,The tonglu county last year from January 1, began to introduce FengXianJin medical liability,The tonglu county health bureau lead,Several medical institutions shall, in accordance with certain proportion pay,And unified management、Use as a whole,LiPeiQuan said,Compared to a commercial insurance,This method on the operation more convenient,This case is through the medical risk'll solve。

  李培泉:后来总共赔了她11万,这也是风险基金里面出的。商业保险的赔付要去催,要去跑,我们现在还有两起比较大的赔偿款没过来,已经一年半了。风险基金用不着我去跑,具体要缴多少,财务科按比例划到帐户上就行,我也可以省很多时间来抓医疗质量。

LiPeiQuan:Later lost her in 110000,This is also a risk fund inside。Commercial insurance claims to push,Have to run,We now have the two larger properly didn't come over,Have a year and a half。Risk funds don't have me to run,Specific how much to pay,The finance in proportion to delimit to account will do,I also can save a lot of time to catch the medical quality。

  目前,桐庐县17家医疗机构都缴纳了医疗风险金,其中包括村级卫生服务中心等基层医疗机构,抱团分担医疗风险。每家医院缴纳的保险金总额不同。桐庐县卫生局医政科科长吴剑波说,推行风险金制度以来,7家医院动用了风险金,去年的赔付总额达到127万多元。

At present,The tonglu county 17 home medical institutions are FengXianJin pay medical treatment,Including the village-level health service center basic-level medical institutions,BaoTuan share the medical risk。The total amount of each hospital pay insurance gold is different。The tonglu county health bureau YiZhengKe section chief WuJianBo said,FengXianJin since the implementation of the system,7 hospitals used the FengXianJin,Last year's compensation amounted to 1.27 million yuan。

  吴剑波:出台这个办法的初衷就是分散或降低医疗机构的医疗责任风险,目前的医疗环境、医疗形势对我们医疗机构或医生来说是不利的。从病人的角度,现在医院里缴了保险金,该赔偿多少也能及时得到补偿,这也是有好处的。

WuJianBo:On the way to the original intention is scattered or reduce medical institutions of medical liability risk,The current medical environment、Medical situation on our medical institutions or a doctor to be unfavorable。From the point of view of the patient,Now the hospital paid the insurance gold,The compensation can be compensated for how much in time,This is also beneficial。

  

专家:此模式或是无奈之举 第三方调解纠纷或更好 experts:The model or helpless for third party dispute mediation or better

  这种医疗风险金制度,为破解医患关系难题打开了新的思路。然而中国政法大学卫生法学教授卓小勤则认为:医院之所以会放弃相对成熟的商业保险产品,选择这样一种创新模式,其实是无奈之举。

This medical FengXianJin system,For solving the doctor-patient relationship problems opens up a new train of thought。But China politics and law university law professor ZhuoXiaoQin argue that public health:The hospital will give up relatively mature commercial insurance products,Choose such an innovative mode,Is helpless actually lifted up。

  卓小勤:医疗风险责任金应该说是一个无奈之举。在此之前各省做了一些由保险公司牵头的医疗责任风险的保险,向医院收保险费,发生医疗纠纷或医疗事故由保险公司赔付。这种保险各地的试行都不是很成功,主要原因在于一方面保险公司是经营行为,还要盈利,真正用于支付保险赔偿的费用有多少不得而知。另一方面,保险公司对医院也做了很多限制,如必须是医疗事故才赔付,没有定为医疗事故就不赔付,也就是说保险公司的尝试并不能满足医院的需求。所以我觉得,几家医院联合设立保险基金,发生医疗纠纷从基金里赔付,这样至少绝大部分费用可以用于支付医疗赔偿,这个经验值得推广。

ZhuoXiaoQin:Medical risk responsibility should say is a gold with trepidation。Before this do some provinces by insurance company takes the lead of medical liability risk insurance,The insurance premium to the hospital,The medical dispute or medical accident happened by insurance company compensate to pay。This kind of insurance from all parts of the trial is not very successful,The main reason is that on the one hand insurance company is management behavior,Will profit,Really used to pay the cost of insurance compensation how many unknown。On the other hand,Insurance company also had a lot of hospital restrictions,Such as medical accident claims must be only,Not as a medical accident is no reimbursement,That is the insurance company to attempt and can't meet the needs of the hospital。So I think,A few hospitals joint establishment insurance fund,Medical disputes occur from fund pays,It is at least most of the fees can be used to pay medical treatment compensation,The experience is worth promoting。

  而中国卫生法学会理事郑雪倩则认为,从现阶段来讲,桐庐的操作模式是一种有益的尝试,但是它也存在比较多的缺陷,如果管理不善,今后可能会存在很多问题。

And China's health law ZhengXueQian director is considered,Will tell from the present,The tonglu operation mode is a beneficial attempt,But it also has more of the defects,If poor management,There may be a lot of problems in the future。

  郑雪倩:这个钱到底算不算是基金,如果是基金的话,我们国家对基金有专门的管理。如基金放在卫生局下,卫生局怎么来管理,资金怎么应用,标准赔付支付等都要形成一系列的规范和制度,才能有效的有生命力的持续下去,不然运行一段时间就会产生问题。

ZhengXueQian:This money after all is not a fund,If is the fund said,Our country to have the special fund management。Such as fund on health bureau,How health bureau to management,Capital how application,Standard pay pay, are form a series of standard and system,To be effective in a living continue,Or run a period of time will cause problems。

  目前,我们国家医患纠纷的调解,主要通过四种途径:一是双方协商,二是通过第三方调解,三是在行政部门组织下调解,四就是通过民事诉讼,通过法院裁定。

At present,Our country the mediation of medical disputes,Mainly through the four kind of way:One is the mutual consultation,It is by the third party mediation,Three is the administrative department under the organization in mediation,Four is through the civil action,Through the court ruled。

  郑雪倩表示,医院更加倾向于后三种调解途径,也就是将调解转移到医院之外,让第三方参与进来,这是医疗纠纷调解的大方向。这样能使医院不会因为医疗纠纷的调解干扰正常的医疗秩序,也能让患者及时得到补偿。

ZhengXueQian said,More likely to hospital after three mediation way,There will be transferred to hospital mediation outside,Let the third party involved,This is the medical dispute mediation of the roads。This can make the hospital won't because of medical dispute mediation interferes with normal medical order,Also can let patients to be compensation。

  郑雪倩:设立学会、协会,或单独在保监会专门设立基金,这样可能更规范。另外,要把纠纷的解决引出去,不要在医院里让医生和患者直接面对面发生纠纷,把它引到第三方,让第三方来处理,对化解医患矛盾促进医患和谐都是有力的。

ZhengXueQian:Set up to、association,Alone or in the circ set up the fund,This may be more regulations。In addition,To draw out the settlement of the dispute,Don't let the doctor in the hospital and patient direct face to face trouble,It led to the third party,Let the third party to deal with,To promote the harmonious doctor-patient conflicts dissolve is powerful patient。

  我们在实践中发现,有50%的病人出现了损害并不是医疗机构的过错,它可能是非医护人员的过错行为,如无过错输血,药品不良反应,或病人体制特异还有一些疾病的严重。这些情况现在我们国家没有一个很好的补偿机制,那么这部分病人的损害补偿,我觉得也可以通过建立基金的形式来解决。(记者富赜 陈瑜艳)

We in the discovery in practice,50% of the patients have the damage is not the fault of the medical institution,It may be resulted from the medical staff fault behavior,If no fault a blood transfusion,Adverse drug reaction,Or the patient system and some serious disease specific。The situation now our country not a very good compensation mechanism,So this part of the patient's damage compensation,I think also can pass build fund form to solve。(Reporter rich Ze ChenYuYan)


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