晏德昌　申帅　晏阳天等

[摘要] 目的 通过实地调查当代各级医院内医务人员和患者间发生纠纷的事例，分析出医患纠纷发生的可能原因，为进一步防止医患纠纷的发生提供理论依据。 方法 实地随机抽取和收集2000年1月～2014年1月湖南省不同级别医院100例曾发生过的医患纠纷案例，按照制定的调查因素进行统计学Meta分析，计算发生概率P，可分析出各个因素发生的概率大小，0≤P≤1有统计学意义，从而可推断出医患纠纷发生的多种原因的相关性。 结果 应用统计学方法分析调查数据得出，国内医患纠纷发生的原因很多，主要有医患沟通理解、医疗费用高、法律法规不健全等问题，我们可以根据发生原因采取相应对策，减少医患之间的矛盾，避免医患纠纷的发生发展。 结论 对于目前日益增多的医患纠纷问题，我们应时时提高警惕，查找相关问题，须采取积极有效的措施预防医患纠纷的发生，从严处理引起医患暴力事件的犯罪分子，对维护好公平公正、合理有序、和谐友好的医疗秩序和就医环境具有重大的现实意义和社会意义。例举和比较国外医患纠纷的发生特点及借鉴国外的预防方法和处理措施，分析国外事例和措施发现相对较少发生医患纠纷事件。

[关键词] 当代医院；医患纠纷；调查与分析

[中图分类号] R197.3 [文献标识码] C [文章编号] 1673-9701（2015）21-0108-05

[Abstract] Objective To analyze the possible causes for medical disputes in order to provide a theoretical basis for further prevention of medical disputes through field investigations of disputes between medical staff and patients at all levels of modern hospitals. Methods All 100 cases of medical disputes which occurred in different levels of hospital in Hu'nan province from January 2000 to January 2014， were randomly selected and collected in field. According to the designed survey factors， statistical meta-analysis was conducted， and the probability P was calculated， so that the probability of occurrence of various factors could be analyzed. It was statistically significant （0≤P≤1）. Thus， the relevance of a variety of causes for medical disputes could be inferred. Results Traditional statistical methods were used to analyze the survey data， and the domestic medical disputes occurred for many reasons， mainly including the insufficient understanding between medical staff and patients， high medical costs， imperfect laws and regulations and other issues. We could take appropriate measures based on the causes so that we could reduce medical disputes and avoid the occurrence and development of medical disputes. Conclusion For the growing number of current medical disputes， we should always be vigilant and find relevant issues. We shall take effective measures to prevent the occurrence of medical disputes， severely deal with criminals who caused the doctor-patient violence， and safeguard fair， reasonable and orderly， harmonious and friendly medical order and medical environment. It is of great practical and social significance. Characteristics of foreign medical disputes are compared and the reference methods of prevention and treatment measures abroad should be learned. The analysis of foreign examples and measures shows relatively less medical disputes.

[Key words] Modern hospitals； Medical disputes； Investigation and analysis

医患纠纷是指医方（医务人员）与患方（患者或者患者亲属）之间因医疗矛盾产生的相互纠纷。当前，医患纠纷包括医疗过错争议产生的医疗纠纷，也包括与医疗过错无关的其他医患纠纷（如欠付医疗费纠纷、患者自身情绪异常引起纠纷等）。……