医患关系困境的制度影响因素及策略分析

摘要

目的 从制度角度探讨医患关系恶化的原因,并从制度角度给出具体的实施建议.方法 运用文献研究法及专题小组讨论法得出医患关系的制度影响因素集合,根据问卷调查结果进行因子分析研究.结果 医患关系深深嵌入到复杂的社会制度体系中,制度、道德文化、目标等8个领域决定医患关系和谐程度,基于因子分析结果,投入制度、强制约束制度和运行与管理制度是医患关系问题的深层制度根源.结论 通过立法建立可持续投入机制,建立解决医患冲突的法律法规、仲裁机制和责任分担制度,采取分级诊疗分化医疗费用压力,加强制度手段对医患关系的统筹管理.%Objective To study the causes of deterioration of the doctor-patient relationship from the view of institution and to give the concrete implementation on institution.Method Applying the method of literature research and focus group discussions to find out the institutional factors influence on the doctor-patient relationship,and doing factor analysis research according to the results of the questionnaire.Result The doctor-patient relationship is deeply embedded in complex social system,including moral culture,institution and aim and so on.Based on results of factor analysis,input system factors,constraint system factors and operation and management factors are the deep roots of problems of doctor-patient relationship.Conclusion Sustainable input mechanism through legislation should be established,the mandatory laws and regulations,arbitration mechanism,and the system of liability share be established to solve the doctor-patient conflicts,hierarchical diagnosis be adopted to differentiate the pressure of medical cost,and the overall effect of institutional means on doctor-patient relationship be enhanced.