新疆生产建设兵团某公立医院医疗纠纷赔付率影响因素分析

通过探索医疗纠纷赔付现况及其影响因素，为改善医患关系、控制医疗纠纷赔付率提供建议，对新疆生产建设兵团某公立三甲医院2002年~2021年发生的医疗纠纷案例共423件进行分析。结果显示医方是造成医疗纠纷赔付的主要原因，占比82.51%，非条件二分类Logistic回归分析表明：骨科(OR=4.670, 95%CI: 1.522~14.322)、普外科(OR=4.910, 95%CI: 1.529~15.768)、外科(其他)(OR=3.139, 95%CI: 1.144~8.610)、医技科(OR=20.490, 95%CI: 3.594~116.804) 为医疗纠纷赔付率的独立危险因素，协商(OR=0.336, 95%CI: 0.147~0.768)途径为保护因素(P＜0.05)。医院要引入医调委解决医疗纠纷案件，对医务人员进行管理、培训，重点关注骨科、普外科、医技科等医疗纠纷赔付率较高的科室。

Influencing Factors of Compensation Rate of Medical Disputes in a Public Hospital in Xinjiang Production and Construction Corps

The study collected 423 medical disputes in a public hospital in Xinjiang Production and Construction Corps from 2002 to 2021, to provide suggestions for enhancing the doctor-patient relationship and controlling the compensations rate of medical disputes by exploring the current status of medical dispute compensations and their influencing factors. The results showed that medical institutions is the main reasons of medical disputes compensation(82.51%), unconditional two-category Logistic regression analysis showed that orthopedics (OR=4.670, 95%CI: 1.522~14.322), general surgical (OR=4.910, 95%CI: 1.529~15.768), surgical (besides orthopedics and general surgical) (OR=3.139, 95%CI: 1.144~8.610), mediation channels (OR=20.490, 95%CI: 3.594~116.804) as independent risk factors for the compensation rate of medical disputes (P < 0.05), negotiation (OR=0.336, 95%CI: 0.147~0.768) as a protective factor. Hospitals should introduce medical investigation committees to solve medical dispute cases, manage and train medical staffs, and focus on departments with high compensation rates for medical disputes such as department of orthopedics, general surgery and medical technology.