1 medical risk concept
1.1 from the hospital management point of view of medical risk (medical risk) concept of definition
(1), "diagnosis and treatment process damage said" medical risk is the uncertainty of the whole process of diagnosis and treatment may lead to loss and disability events and all possible unsafe events. And may occur all the unsafe events, such as medical malpractice, medical errors, medical accidents and complications.
(2), "medical accident damage" medical risk refers to the unintentional, unintended, unplanned medical accidents in the treatment and care of the patient's body damage, which is not the same as the treatment and care of medical negligence caused by medical accidents (medical errors).
(3), "total loss" Duke University of the United States of America on the definition of medical risk is "the possibility of loss". This loss can be both the harm to patients, but also the cost of the hospital to suffer claims for this, including the hospital to lose market share.
(4), "fault damage" in the process of medical services, the occurrence of medical error or negligence caused by the patient's death, disability, as well as damage to body tissues, physiological functions and mental health and other unsafe events.
The above four concepts of medical risk are of great significance to the management of medical safety in hospitals. In order to provide comprehensive management of medical risk, it is necessary to redefine the connotation and extension of medical risk, so that clinical medicine medical risk control, medical tort civil litigation and social security application of a unified concept of medical risk.
1.2 Definition of the concept of medical risk from the perspective of comprehensive management
The sociological theory of risk holds that the basic characteristics of risk are the objective potentiality, the size of the loss, and the uncertainty of whether it will occur or not. The understanding of the connotation of the concept of risk is basically the same in all fields, and it is believed that the core essence of risk is uncertainty. However, different research fields have different scopes and emphases, and the definition of the conceptual extents of risk shows significant differences. The focus of defining the concept of medical risk is to clarify its extension, that is, to clarify the scope, nature and content of medical damage, and to make the necessary amendments to the connotation of risk***ness according to the characteristics of this field.
(1), non-essential medical damage injury epidemiology of injury is defined as injury, where the transfer of energy (mechanical, thermal, electrical, chemical or radioactive energy, etc.) or interference exceeds the body's tolerance, resulting in tissue damage, asphyxiation leading to oxygen deprivation and irritation caused by trauma are called injury. According to this definition, the medical damage can be defined as: due to the diagnosis and treatment behavior caused by the patient's physical injury, mental trauma, and the corresponding property damage.
From the clinical point of view, the diagnosis and treatment of patient damage caused by the behavior of two cases: a necessary medical damage, a non-necessary medical damage. Necessary medical damage is for the diagnosis and treatment of disease necessarily occurs to the patient limited damage, such as lumbar puncture, injection damage to the skin, subcutaneous tissue, cancer patients with radiotherapy, chemotherapy and surgical treatment damage to normal tissues and organs, etc.. Non-essential medical damage refers to the damage that does not contribute to the realization of the purpose of diagnosis and treatment, or even the opposite of the purpose of diagnosis and treatment, necessary medical damage is non-essential medical damage if it exceeds the reasonable limit.
Necessary medical damage is certain to occur, doctors and patients can clearly foresee the situation and limited choice, and sometimes there is no choice, even if very reluctant, but also can only be accepted, which does not belong to the category of medical risk; non-essential medical damage is in a potential state before the occurrence of the damage can be predicted and damage can be predicted, but can not determine the size of the damage. The nature of non-essential medical damage is fully consistent with the characteristics of risk, but also more clearly delineate the scope of medical risk.
The results of non-essential medical damage include causing disease (also known as medically induced disease), disability or even death and corresponding property damage. From the object of damage, excluding the damage to other specific personality rights (such as the right to name, privacy, etc.), from the cause of the damage is limited to the diagnosis and treatment behavior, does not involve the diagnosis and treatment process of other factors, such as the quality of medicines, medical instruments and equipment quality and other issues. For the right to life, unless the legislation provides for euthanasia, there is no reason for any necessary medical damage.
(2), the possibility of medical risk and uncertainty possibility is uncertain but can be predicted that most of the state of events can be expressed in terms of probability, but the probability did not reach a high probability of the state of danger; Uncertainty is that can not be determined is also difficult to predict the state of events, generally can not be expressed in terms of probability, even if the available probability of probability is also very small (small probability of events). In the absence of an expanded explanation of "uncertainty", it is inaccurate to use uncertainty alone as a connotation of risk.
The risk of the medical treatment can be defined as the likelihood or uncertainty that the diagnosis, treatment, and care of a patient will result in nonessential medical harm.