中醫醫療糾紛與醫師責任保險之評估研究

陳俞沛
台灣中醫診斷學會
本研究旨在以實證調查輔以質性研究之方式,從中醫發生醫療糾紛的頻率、不同人口特徵、中醫師面對醫療糾紛的因應方式、中醫師對醫師責任保險的相關意見三方面來探討中醫醫療糾紛與後續理賠相關問題，本研究目的是對中醫醫療糾紛之預防與處理提出醫療、法律及保險等相關建議，期待能建構中醫醫療糾紛之運作處理機制，引進中醫醫療責任保險，分散中醫師執業風險，並協助處理醫療糾紛理賠事宜，以促進醫病關係和諧並提升中醫服務品質。
本研究擬以問卷調查為實施方法，參考並修正過去相關研究文獻，並廣邀醫療、保險以及法律各界專家學者提供意見，以做為問卷設計的依據，本研究問卷內容問題擬分四種型態，如單選題、複選題及依李克特量表(Likert Scales)五項測量尺度設計的態度量表由受試者勾選，並佐以開放式問題，設計能自由填寫姓名之聯絡欄位，邀請有意願的中醫師，參與本研究深度訪談或北中南三區焦點座談，以收集更詳盡的資料並輔助問卷的分析結果。問卷初步完成後，以便利抽樣方式發放20份問卷實施問卷前測，修正語意不清之問題後，正式實施全國中醫師問卷調查。本研究的研究對象擬取自於全國各縣市的中醫師公會中醫師，其總數於98年度預估將可能達到5300名左右。因考量母體龐大且醫師族群的問卷拒訪率可能偏較高，故為提高問卷回收率，本研究擬利用各縣市中醫師公會舉辦的在職教育演講活動場合，於醫療法律課程時，當場發放與回收問卷，而未能當場填寫問卷之中醫師則以事後郵寄方式發放問卷，如此應可達較高的回收率。此外，本研究擬廣邀專家學者與自願參與談會之中醫師，於北中南三區各舉行一場焦點座談會，以增加資料的多元性與豐富性。
在資料分析工具方面，擬以SAS套裝軟體進行統計分析，建立描述性統計資料、因素分析、迴歸分析等等資料，另外本研究彙整歸納問卷中開放性問題的答案，並將歸納彙整之結果與相關統計資料相互映證，用以闡釋研究結果，進一步解釋相關數據。
關鍵字：中醫；醫療糾紛；醫師責任保險

Research of Medical Malpractice on Chinese Medicine and Medical professional liability insurance

Yu-Pei Chen
Formosan association of Clinical Diagnosis in Traditional Chinese Medicine
Formosan association of Clinical Diagnosis in Traditional Chinese Medicine
The research aims at providing some suggestions about handling and prevention of medical malpractice in Chinese medicine from aspects of medicine, insurance and law. The approach we take in the study is experimental survey for the most part, and qualitative research would play an ancillary role. Furthermore, we would research the related issues of mentioned medical malpractice and indemnity in Chinese medicine from several aspects, ranging from the frequency of medical malpractice in Chinese medicine, to different demographic characteristics, and to Chinese medicine doctors’ opinions regarding medical professional liability insurance. The goals we attempt to attain are to construct a system capable of coping with medical malpractice in Chinese medicine, diversifying Chinese medicine doctors’ professional risk, and assisting Chinese medicine doctors in dealing with medical malpractice, so as to promote the relationship between doctor and patients and hence quality of Chinese medicine.
We plan to take survey as our tool, and to amend previous questionary according to medicine, insurance and law experts’opinions. The questions in our questionary come in four forms, ranging from multi-choice questions, multi-select questions, and to questions based on Likert Scales. Volunteer Chinese medicine doctors would be invited to take part in our interviews or symposiums held in north, central, and south district as scheduled. Through these measures, we can gather more detail information to adjust the results of our questionary. After questionary is completed, twenty questionaries would be previously used to act as benchmark. In accordance with these questionaries, we would amend ambiguous questions further. Subjects of the study would focus on Chinese medicine doctors from every association all over the country. The expected number of these Chinese medicine doctors is up to 5300 in 2008. In view of large number of specimens and a law rate of volunteers, we decide to hand over and take back our questionaries on the occasion of on-the-job training held by every Chinese medicine association. On the other hand, those who don’t attend these trainings would receive our questionaries by mail. 
As far as analysis tools are concerned, we would apply SAS software to statistics, establishing descriptive statistic data, factors analysis, regression, and so on. Moreover, we would analyze the answers of open questions in the questionaries, and compare the results to related statistic data in order to illustrate our results and related figures.
關鍵字：Chinese Medicine；Medical Malpractice；Medical professional liability insurance