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A risk prediction model for medical conflict in emergency departments
Fengjiao Gu1, Junlin Huang2, Yingqian Zhang1,3
1Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Objective:
This study aims to identify and analyze patient-related risk factors that lead to medical conflict in emergency departments and to build a patient-related risk prediction model, which can serve as a tool for medical professionals to prevent medical conflict in emergency departments.
Background:
At present, the research on the countermeasures of medical conflict in emergency departments mainly focuses on post-event coping strategies and rarely addresses the early warning of conflict occurrence.
Methods:
Through a retrospective analysis of medical conflict events in the emergency pre-examination and rescue areas, 105 conflict cases and 525 non-conflict cases were collected. Univariate analysis, neural network analysis and support vector machine (SVM) were performed to analyze patient-related risk factors in medical conflict, thereby constructing a prediction model.
Results:
Neural network analysis yielded an accuracy of 96.4% (sensitivity: 91.2%, specificity: 97.7%) and an area under the ROC curve of 0.966. The order of importance of risk factors included in the prediction model is in descending order of importance: waiting time; patient non-compliance to the treatment process; patient's skepticism toward care; number of caregivers; medical professionals' failure to respond to patients' needs; and history of psychosomatic diseases. The SVM utilizing 10-fold cross-validation demonstrated an accuracy of 96.4% in independent testing samples, with a sensitivity of 91.2% and a specificity of 97.2%.
Conclusion:
This model may accurately predict the occurrence of medical conflicts in emergency departments with high accuracy, providing a theoretical basis for preventing medical conflicts.
Implications For Management:
We have developed a risk prediction model to help emergency medical professionals identify factors that may contribute to preventing medical conflict, reducing conflict events, and enhancing the doctor-patient relationship.
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