中国卫生政策研究
中國衛生政策研究
중국위생정책연구
Chinese Journal of Health Policy
2015年
9期
53-57
,共5页
注册前%临床实践培养%执业现状%合法性
註冊前%臨床實踐培養%執業現狀%閤法性
주책전%림상실천배양%집업현상%합법성
Pre-registered%Clinical practice training%Practice situation%Legality
目的：从法律角度分析我国“注册前”临床实践人员无资质参与临床执业的现状，为完善《执业医师法》提供政策依据。方法：通过整群抽样的方法，集中选择北京等地区较早开展住院医师规范化培训的大型临床教学医院，针对“注册前”临床实践者、临床带教教师及卫生行政管理者开展定量调查，进行统计描述并应用卡方检验进行组间率的比较。同时，对北京朝阳区和海淀区人民法院近3年的764起医疗纠纷案件进行描述性统计分析。结果：“注册前”临床实践人员，存在独立出诊、单独值班、独立处置患者、独立操作有创技术、独立书写病历等违规情形；带教教师的现场督导亦存在缺位，医疗纠纷时有发生。建议：从立法、资格认证、医师资质考试等多角度确立“注册前”实践人员从事临床工作的法定资格，并针对“执业医师指导下”存在的法律问题提出解决方案。
目的：從法律角度分析我國“註冊前”臨床實踐人員無資質參與臨床執業的現狀，為完善《執業醫師法》提供政策依據。方法：通過整群抽樣的方法，集中選擇北京等地區較早開展住院醫師規範化培訓的大型臨床教學醫院，針對“註冊前”臨床實踐者、臨床帶教教師及衛生行政管理者開展定量調查，進行統計描述併應用卡方檢驗進行組間率的比較。同時，對北京朝暘區和海澱區人民法院近3年的764起醫療糾紛案件進行描述性統計分析。結果：“註冊前”臨床實踐人員，存在獨立齣診、單獨值班、獨立處置患者、獨立操作有創技術、獨立書寫病歷等違規情形；帶教教師的現場督導亦存在缺位，醫療糾紛時有髮生。建議：從立法、資格認證、醫師資質攷試等多角度確立“註冊前”實踐人員從事臨床工作的法定資格，併針對“執業醫師指導下”存在的法律問題提齣解決方案。
목적：종법률각도분석아국“주책전”림상실천인원무자질삼여림상집업적현상，위완선《집업의사법》제공정책의거。방법：통과정군추양적방법，집중선택북경등지구교조개전주원의사규범화배훈적대형림상교학의원，침대“주책전”림상실천자、림상대교교사급위생행정관리자개전정량조사，진행통계묘술병응용잡방검험진행조간솔적비교。동시，대북경조양구화해정구인민법원근3년적764기의료규분안건진행묘술성통계분석。결과：“주책전”림상실천인원，존재독립출진、단독치반、독립처치환자、독립조작유창기술、독립서사병력등위규정형；대교교사적현장독도역존재결위，의료규분시유발생。건의：종입법、자격인증、의사자질고시등다각도학립“주책전”실천인원종사림상공작적법정자격，병침대“집업의사지도하”존재적법률문제제출해결방안。
Objective:To understand the current situation about pre-registered medical practitioner's ineligible practice from a legal point of view and provides references for"the Law of Medical Practitioners".Methods:The sur-vey is based on cluster sampling method which centralized the selected large clinical teaching hospitals which have launched the standardized residents training.The research is focused in Beijing and involves three kinds of people in-cluding the pre-registered medical practitioners, clinical teaching teachers and health administrators.The descriptive statistics and the Comparison rates between groups by chi-square test rates were adopted.Meanwhile, the 764 medi-cal malpractice cases from the past three years were analyzed in the Courts of the People of Haidian and the Beijing Chaoyang Districts.Results:The clinical trainees“pre-registration” made illegal situations such as independent vis-its, finding a single worker on duty, independent patient disposal, invasive technology's independent operation, inde-pendently writing the medical records, and the absence of tutors on the supervision sites.All of these mischiefs en-hanced the occurrence of medical disputes.Suggestions: Based on the current situation, it is necessary to establish the legal qualifications for the“pre-registered” trainees engaged in the accredited clinical work legislation, physician qualification examination, and in so many angles.Proposing solutions based on legal issues about “the practitioner guidance” should also be efficient.
