Medical behaviors involve multi level and multi subject legal relations. In the process of medical and nursing care, there are two categories of legal relations concerning medical behaviors. They are external and internal legal relations. External legal relations involve legal relations between hospitals, between physicians and patients and between major medical accidents and penalties; internal legal relations involve physicians, nurses and hospital authorities.
Objective To summarize and analyze the experience of Canadian hospital report, including report contents, indicators system and result application, so as to provide basis for improving Chinese hospital information report and enhancing healthcare regulation. Methods Official networks and databases in Canada were searched, and relative policies, documents, research reports and information reports were included. Results Canadian Hospital Report Project carried out by Canadian Institute for Health Information was effective for gathering and comparing hospitals’ information, and regulating healthcare service. Ontario Hospital Report Project, as a local policy based on national hospital report project, was a good example of local government to improve healthcare service regulation. Conclusion Canadian Hospital Report and Ontario Hospital Report enlighten us that, carrying out the comparison of hospitals in the same type, ensuring the comparability of data, setting comprehensive and scientific report contents and indicators, and emphasizing the self-evaluation function and self-improvement function of the hospital performance evaluation.
Objective To summarize and analyze the working experience of hospital performance evaluation and reporting system in America, so as to provide decision support to China on such work as establishing objective, scientific and effective hospital performance evaluation system, strengthening government’s supervision to health service, and promoting hospitals’ sound development.Methods American official websites and databases were searched to include relative policies, reports and documents on hospitals’ performance evaluation. Results Typical hospital performance evaluation and reporting system in America included National Healthcare Quality Report (NHQR), Consumer Assessment of Healthcare Providers and System (CAHPS), Healthcare Effectiveness Data and Information Set (HEDIS), Leapfrog Group Evaluation System and Thomson Reuters 100 Top Hospitals. Conclusion The enlightenments of American performance performance evaluation systems to China include: a) more attention should be paid to performance evaluation; b) combined evaluation models and results application methods should be considered; c) comparatively scientific evaluation methods and comprehensive evaluation contents should be established.
提高医疗服务质量、确保病人安全是当前医学教育及培训面临的巨大挑战。今天的医生及医务工作者 应具备良好的沟通能力,掌握如何在临床实践中鉴别、预防和处理不良事件及接近过失事件(near misses),如何使 用当前获得的证据及相关信息,如何安全有效地在团队中工作,如何在实践中教授和学习病人安全知识,如何根据 认可的伦理原则服务公众。
At present, the conclusion of technical appraisal of medical malpractice is the key to decide and deal with medical malpractice. The initiation mode of technical appraisal may be entrusted by both parties involved, handed over by the healthy administration department, or designated by the People＇s Court. Because it exerts a direct impact on the result of medical dispute, the conclusion of technical appraisal must undergo examination by the medical association, the health administration department, and the court. The conclusion plays different roles in cases of compensation for medical personal injury and of medical service contract disputes. To interpret and apply the technical appraisal and its conclusion correctly, we have to understand clearly the nature of technical appraisal of medical malpractice, recognize and handle skillfully the relation among identification-related issues such as the judge＇ s personal discretion, signature of the appraiser, the appraiser＇ s being present at the hearing and questioned, and the expert witness.
目的 了解近年四川省基层医疗卫生机构医疗服务的变化情况。 方法 对“四川省卫生统计数据采集与决策支持系统”收集的2002年－2011年年报数据进行分析。 结果 10年来，四川省基层医疗卫生机构医疗服务数量增加，效率提高，药费占医药费用的比例下降。 结论 10年卫生改革的有关政策特别是新医改的实施，对基层医疗卫生机构医疗服务起到较大的推动作用，四川省“保基本，强基层”的战略目标正在逐步实现。