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看“宁波解法”如何化解医患纠纷

2017-11-18 尹明 医院管理论坛报

医疗纠纷只能“私了”?怎样的解决方法更利于化解?快来借鉴下“宁波解法”破解医患纠纷取得了一定效果。

对于每家医疗机构来说,医疗纠纷是件头疼的事,遇到医疗纠纷只能“私了”?怎样的解决方法更利于化解?“宁波解法”破解医患纠纷取得了一定效果,借鉴起来吧。

医疗纠纷只能“私了”?

以往,处理医疗纠纷有三条途径——“私了”、“官了”、“官司了”。医疗纠纷“宁波解法”,以“一条原则,两个机制,三点突破,四方合作”模式有效化解医患纠纷,值得全国医疗机构借鉴、推广。

以往处理医疗纠纷的三条途径:一是“私了”——自行协商。缺点:对抗性强,易出现医闹。二是“官了”——行政调处。缺点:患者对卫生行政部门的调解,包括医疗事故鉴定在内存有不信任。三是“官司了”——法院诉讼。缺点:诉讼要经历医疗事故鉴定和法医鉴定,不仅诉讼过程时间长,还需支付大笔鉴定费,所以大多数人不选择司法途径。

2008年3月1日,宁波市以政府令的形式,颁布实施了 《宁波市医疗纠纷预防与处置暂行办法》。2012年,经省人大常委会批准,升格为《宁波市医疗纠纷预防与处置条例》,成为全国首部关于医疗纠纷预防与处置的地方性法规。“宁波解法”自实施以来取得了良好效果,得到了业内外人士的广泛肯定,被认为是解决医疗纠纷的有效“解法”。

“宁波解法”如何破解医患纠纷

“宁波解法”用一句话来概括就是“一条原则,两个机制,三点突破,四方合作”。下面对宁波的做法一一给予诠释。

★一条原则

遵循预防为主、依法处置、公平公正、及时便民的原则,为医患双方提供免费、依法、公平、便捷的公共服务产品。强调预防为主,应将预防放在第一位。

★两个机制

实施医疗责任保险理赔协商机制和医疗纠纷人民调解机制,这是“宁波解法”的核心与灵魂。

1.医疗责任保险理赔协商机制

目前,宁波市有五家保险公司负责全市医疗纠纷补偿,并且宁波市所有公立医疗机构都参加了医疗保险。

宁波医疗责任保险和其他地区不一样的地方在于,医疗机构不但购买保险,而且还购买了理赔服务。从医疗纠纷一开始,保险就参与整个医疗纠纷处置的过程,包括调查、处置和协商。宁波市设有一个理赔中心,下设几个分中心,这些中心做到了24小时全天候服务。理赔中心接到电话后,相关人员会在第一时间赶赴现场,并全程参与医疗纠纷的调解。在医疗纠纷处置之后,理赔中心还要向卫生行政部门提出防范意见和建议。

2.医疗纠纷人民调解机制

为了体现医疗纠纷调解的公平性,医疗纠纷人民调解委员会挂靠在司法局,医疗纠纷人民调解委员会由财政全额拨款,参与医疗纠纷调解是不收取费用的。

医疗纠纷人民调解委员会的责任主要是调解,保险所起到的作用就是协商,两个机制是相互协作、相互促进的。医疗纠纷发生后,1万元以下,医疗机构有权进行处理;1万元以上,医疗机构不能自行解决,要么通过保险赔,要么寻求人民调解。患方索赔金额在10万元以上的,必须申请医学鉴定,以明确医疗损害侵权责任和程度。

★三点突破

1.统一赔偿标准; 2.设置协商赔付界线;3.加大医闹打击力度。

过去,不同的医疗机构之间,赔偿标准是不同的。现在,对同一类型的医疗纠纷,宁波市做到了赔偿标准一致。同时,宁波市还设置了赔付界限。在打击医闹层面,在公安部门的支持下,宁波市做出了一些规定,在一些重大医疗纠纷比如发生停尸时,现场民警有权移尸。

★四方合作

明确了公安、司法、卫生、保监等政府部门职责。医疗纠纷发生是全社会共同的责任,这些部门甚至包括媒体都应该密切合作,这样才能减少纠纷的发生。

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    2017-11-20 millore
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    2017-11-20 ewsr5
  4. [GetPortalCommentsPageByObjectIdResponse(id=1284697, encodeId=60e0128469e83, content=<a href='/topic/show?id=da9934342b5' target=_blank style='color:#2F92EE;'>#医患#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34342, encryptionId=da9934342b5, topicName=医患)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c0e3195, createdName=millore, createdTime=Mon Nov 20 01:16:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1391567, encodeId=e1dd139156e5f, content=<a href='/topic/show?id=c7e934364c1' target=_blank style='color:#2F92EE;'>#医患纠纷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=34364, encryptionId=c7e934364c1, topicName=医患纠纷)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Mon Nov 20 01:16:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536397, encodeId=61da153639e00, content=<a href='/topic/show?id=c054e70973c' target=_blank style='color:#2F92EE;'>#纠纷#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77097, encryptionId=c054e70973c, topicName=纠纷)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74d012693594, createdName=ewsr5, createdTime=Mon Nov 20 01:16:00 CST 2017, time=2017-11-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=262246, encodeId=232026224621, content=谢谢分享学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=2, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM7GibvIBibibnnnvpajk2stlDF5oichYahI6Bia8uxeTBFoPbdoHWebyXf9eal9FNgUF2lNcrwoZicM3BvQ/0, createdBy=a3742066385, createdName=戒馋,懒,贪, createdTime=Sat Nov 18 10:54:33 CST 2017, time=2017-11-18, status=1, ipAttribution=)]
    2017-11-18 戒馋,懒,贪

    谢谢分享学习了

    0

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