评估医疗服务质量的法律问题

E. Netesin, V. Gorbachev, N. Utkin
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引用次数: 0

摘要

对医疗保健不良后果的分析有助于查明原因,消除其再次发生的可能性,并有助于积累实际经验。目标。确定医疗机构、保险公司和调查机构进行的医疗质量检查的相关性程度,并评估使用"提供医疗服务的缺陷"一词的有效性。材料和方法。主要的研究方法是分析致命后果研究委员会的结论、对保险公司进行的质量检查的检查行为和法医检查的结论,以便对"提供医疗服务的缺陷"、"医疗差错"、"提供医疗帮助的缺点"等用语的使用频率进行分析。这些数据来自对24项社会保障组织协议、保险公司进行的15项质量检查行为和12份法医检查报告的研究结果。在所有病例中,研究的文件都与麻醉医师-复苏员参与的医疗护理的不良后果有关。结果。在分析这些文件时发现,在法医检查的结论中更经常出现"提供医疗服务方面的缺陷"一词,占91.7%。在审查医疗服务质量时,这一术语仅占13.3%,在CSLO协议中占54.2%,而"提供医疗服务方面的缺陷"占41.6%。结论。分析显示,在反映护理质量的文件中,有一个含义和内容不同的术语,无法客观反映所承认的缺陷的程度及其对疾病结果的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Legal aspects of assessing the quality of medical care
The analysis of adverse outcomes of medical care allows to identify the causes and eliminate the possibility of their further recurrence, and contributes to the accumulation of practical experience. Objectives. To determine the degree of correlation of examinations of the quality of medical care conducted by medical organizations, insurance companies and investigating authorities, and to assess the validity of using the expression “defect in the provision of medical care”. Materials and methods. The main research method was the analysis of the conclusions of the Commission for the Study of Lethal Outcomes (CSLO), acts of inspections of the quality examination conducted by insurance companies and the conclusions of forensic medical examinations for the frequency of use of the expression “defect in the provision of medical care”, “medical error”, “shortcomings in the provision of medical help”. The data was obtained from the results of a study of 24 CSLO protocols, 15 acts of quality examination inspections conducted by insurance companies and 12 forensic medical examination reports. In all cases, the studied documents were associated with adverse outcomes of medical care, with the participation of anesthesiologists-resuscitators. Results. When analyzing these documents, it was found that the expression “defect in the provision of medical care” is more often found in the conclusions of forensic medical examinations - 91.7 %. When examining the quality of medical care, this term is found in only 13.3 % and in the protocols of CSLO in 54.2 %, and “deficiencies in the provision of medical care” - і n 41.6 %. Conclusions. The analysis revealed that in the documents reflecting the quality of care, there is a terminology that is different in meaning and content, which does not allow to objectively reflect the degree of the admitted deficiency and its іmpact on the outcome of the disease.
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