日本における医療ミスと法的解決システム
K Nakajima1, C Keyes, T Kuroyanagi
1Department of Social and Environmental Health F2, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita-shi, Osaka 565-0871, Japan. kazuen@pbhel.med.osaka-u.ac.jp
JAMA
|April 13, 2001
まとめ
日本の医療ミス請求は増えているが,西洋諸国よりもまだ頻度が低い. 最高裁判所と日本医療協会 (JMA) のデータによると,過去30年間で訴訟と賞金の増加が見られます.
科学分野:
- 医療法 医療法 医療法について
- 保健政策 保健政策 保健政策
- リスク管理 リスク管理
背景:
- 西洋社会では,医療ミスが医療の質や患者補償に与える影響を徹底的に研究しています.
- 日本の医療ミス環境は,データの機密性のために,まだ十分に理解されていません.
- 既存の研究では,日本の医療不当行為の請求や紛争解決に関する包括的な分析が欠けている.
研究 の 目的:
- 日本における医療過失責任制度と,過去30年にわたる請求頻度を見直す.
- 日本における医療過失訴訟と賠償の動向を分析する.
- 日本の医療制度における紛争解決メカニズムの有効性を評価する.
主な方法:
- 日本の最高裁判所,保健労働福祉省,日本医学会 (JMA) のデータ分析.
- 1970年から1998年までの不正行為の請求頻度と責任保険料の調査.
- JMAメンバー間の請求データと公的に利用可能な裁判所記録の比較.
主要な成果:
- 日本の地方裁判所に提出される医療過失訴訟の年間数は,1970年の102件から1998年には629件に増加した.
- 89,300ドルを超える賞金の割合は,1976年の13.6%から1987年の65.4%に大幅に上昇した.
- JMAメンバーのクレームは31% (1987年-1999年) 増加したが,クレーム頻度は約100人の医師に0.3で安定したままだった.
結論:
- 医療ミス請求は,米国,英国,ドイツと比較して全体的に頻度が低いにもかかわらず,日本では増加しています.
- JMAの裁判所外の審査は,より速く,より安価ですが,抑止力や規律のために無効です.
- すべてのクレームに関する限られたデータは,日本における包括的な評価,リスク管理,医師教育を妨げています.
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