Causes, Characteristics, and Risk Factors of Medical Damage Liability Disputes: A 13-Year Retrospective Analysis of...

Objective: To investigate the occurrence trends, distribution characteristics, and contributing factors of medical damage liability disputes in Chongqing from 2012 to 2024, thereby providing data support for risk prevention and control in regional medical institutions and for health policy formulation. Methods: A retrospective study design was employed. Adjudication documents pertaining to medical damage liability disputes in Chongqing, spanning from January 2012 to December 2024, were retrieved from the China Judgments Online database. A total of 1761 eligible cases were selected based on standardized criteria. Statistical analysis was conducted on core case variables. Results: The number of cases exhibited a fluctuating upward trend from 2012 to 2024, peaking in 2019 (276 cases) before subsequently declining. The average actual compensation amount demonstrated a steady increase, reaching its highest level in 2023 (259,200 ± 53,900 CNY). Deficiencies in diagnostic and therapeutic procedures constituted the predominant cause of disputes (50.37%). Surgical departments (46.05%) and orthopedics departments (22.60%) were identified as high-risk specialties. Tertiary public hospitals accounted for the highest proportion of disputes (48.89%) and the highest average actual compensation (216,100 ± 10,600 CNY). Regarding the apportionment of liability, secondary liability attributed to the medical provider was the most frequent (29.59%). Patient death was the most common adverse outcome (37.14%). The highest average compensation amount was associated with persistent vegetative state outcomes (777,500 ± 157,200 CNY). Statistically significant differences in actual compensation amounts were observed across all outcome categories (all p < 0.05). Conclusions: The situation concerning medical damage disputes in Chongqing remains severe. The etiologies of disputes are predominantly attributable to medical technical factors-particularly deficiencies in diagnostic and therapeutic procedures-and failure to fulfill a duty of care, both of which are associated with elevated compensation amounts. Given that this study employed a retrospective descriptive design, the aforementioned findings reflect associations among variables rather than causal relationships. Based on the identified risk hierarchy, it is recommended that priority be given to strengthening perioperative safety verification and re-certification of critical procedural skills in high-incidence departments, such as surgery and obstetrics and gynecology, enhancing informed consent and medical record quality management, and advancing the tiered healthcare delivery system, with a view to reducing medical risks and mitigating doctor-patient conflicts.