Association between hospital legal constructions and medical disputes: A multi-center analysis of 130 tertiary hospitals in Hunan Province, China

Abstract

BackgroundMedical disputes are common in hospitals and a major challenge for the operations of medical institutions. However, few studies have looked into the association between medical disputes and hospital legal constructions. The purpose of the study was to investigate the relationship between hospital legal constructions and medical disputes, and it also aimed to develop a nomogram to estimate the likelihood of medical disputes.MethodsBetween July and September 2021, 2,716 administrators from 130 hospitals were enrolled for analysis. The study collected seventeen variables for examination. To establish a nomogram, administrators were randomly split into a training group (n = 1,358) and a validation group (n = 1,358) with a 50:50 ratio. The nomogram was developed using data from participants in the training group, and it was validated in the validation group. The nomogram contained significant variables that were linked to medical disputes and were identified by multivariate analysis. The nomogram's predictive performance was assessed utilizing discriminative and calibrating ability. A web calculator was developed to be conducive to model utility.ResultsMedical disputes were observed in 41.53% (1,128/2,716) of participants. Five characteristics, including male gender, higher professional ranks, longer length of service, worse understanding of the hospital charters, and worse construction status of hospital rule of law, were significantly associated with more medical disputes based on the multivariate analysis. As a result, these variables were included in the nomogram development. The AUROC was 0.67 [95% confident interval (CI): 0.64–0.70] in the training group and 0.68 (95% CI: 0.66–0.71) in the validation group. The corresponding calibration slopes were 1.00 and 1.05, respectively, and intercepts were 0.00 and −0.06, respectively. Three risk groups were created among the participants: Those in the high-risk group experienced medical disputes 2.83 times more frequently than those in the low-risk group (P < 0.001).ConclusionMedical dispute is prevailing among hospital administrators, and it can be reduced by the effective constructions of hospital rule of law. This study proposes a novel nomogram to estimate the likelihood of medical disputes specifically among administrators in tertiary hospitals, and a web calculator can be available at https://ymgarden.shinyapps.io/Predictionofmedicaldisputes/.

The Efficacy of Rule of Law Publicity Short Video Platforms in the Prevention of Medical Disputes Among Healthcare Professionals: A Propensity Score Analysis

“…We identified several unmodifiable risk factors that contribute to the occurrence of medical disputes among healthcare professionals. These findings are consistent with previous studies, 2,3,15,[21][22][23] which further strengthen their significance. Recognizing and addressing these unmodifiable risk factors can empower healthcare institutions and policymakers to develop targeted interventions and strategies that effectively address the specific challenges faced by healthcare professionals at higher risk of medical disputes.…”

“…Previous studies have also shed light on this matter, with a study among hospital administrators reporting a prevalence of 41.53%. 2 Additionally, varying populations and regions have exhibited a prevalence ranging from 34.1% to 46.06%. 15 The significance of these findings was further underscored by a nationwide survey conducted in China in 2021, which revealed that 31.06% of doctors have grappled with medical disputes involving patients.…”

“…Medical disputes are a pervasive issue within the healthcare system, consistently causing disruptions and challenges for medical institutions. 1,2 These disputes have profound implications for the individuals involved, including patients, their families, and healthcare professionals. 3 Healthcare professionals may face tremendous stress, reputational damage, and increased professional accountability from these disputes, 1 and patients may experience physical and psychological harm, resulting in prolonged suffering, loss of trust in the healthcare system, and disrupted doctor-patient relationships.…”

The difference in patient-centered medical experiences between public fertility care and private fertility care in China: A multicenter cross-sectional study

“…To promote the transformation of public hospitals from "disease-centered" to "patient-centered", it is important that they establish and improve medical services, such as high-quality nursing services and satisfaction management, allow the support of information technology in medical care, constantly enhance the continuity of medical services, integrate patient safety management into every link of hospital management, achieve continuous improvement, and form a new service model of public hospitals. At the same time, it is important to further improve medical services and patients' experiences to improve doctor-patient communication and medical dispute prevention and handling mechanisms [25][26][27]. Therefore, high-level hospitals with strong in uence and radiation effects and outstanding comprehensive advantages should be selected to build provincial regional medical centers, improve the comprehensive carrying capacity of medical and health services in different regions, better meet the needs of medical services in the region and reduce the cross-regional ow of patients.…”

Analysis of the characteristics, efficiency, and influencing factors of third-party mediation mechanisms for resolving medical disputes in public hospitals in China using 5,948 cases

“…However, research on medical dispute resolution methods has focused more on litigation [29][30][31][32][33][34][35]; some studies have emphasized the role of mediation, but research into the characteristics, e ciency, and in uencing factors of TPM in resolving medical disputes using a large number of detailed cases is lacking [19,27,29,36]. Therefore, we analyzed TPM practices using data from 5,948 cases in Chinese public hospitals from 2014 to 2019 in Gansu, a western province in China.…”