[국내논문]국내 판례분석을 통한 의료사고 예방대책 연구 - 외국인 환자 의료사고 예방을 중심으로 A study on preventive strategies of medical accident through analyzing medical disputes- centered on foreign patients원문보기
이 연구는 외국인 환자 의료사고 예방을 목적으로 국내 의료분쟁 판례 630개를 내용분석(content analysis)으로 분석한 것이다. 주요 연구결과로는 산부인과의 경우가 특징적이었는데, 다른 과목에 비해 인용비율이 낮고, 설명의무 위반에서 문제제기 및 인정비율도 낮았다. 반면 최근의 의료관광으로 외국인 환자 비율이 높은 전공과목인 피부과와 성형외과에서의 설명의무 위반 비율은 높게 나타났다. 전공과목별 판결시, 인용액은 상대적으로 산부인과와 소아과가 높은 반면 외과, 정형외과, 신경외과의 인용액이 내과, 신경과, 정신과에 비해 낮았다. 의료과실이 문제가 되고 인정되는 경우는 수술과 시술, 진단, 환자관찰 영역 순으로 많은데 반면, 의료과실의 인정되는 경우는 환자전원, 의료시설, 환자안전 등에서 높았는데, 특히 환자전원은 의료과실이 인정되는 데 중요한 요소로 밝혀졌다. 최근 의료분쟁에서 설명의무가 점점 중요해지고 있는데 외국인 환자의 경우 문화적, 언어적 차이로 인한 의사소통의 문제를 감안할 때 더욱 중요하다. 위의 연구결과에 기반하여 주요 법적 쟁점으로 설명의무, 전원, 시설 및 환자관리가 도출되었다. 본 연구에서는 외국인 환자를 위한 의료사고 예방 대책으로 중재기관을 통한 해결 등과 같은 비사법적 해결방법 외에 의사-환자 간 효과적인 의사소통 개발과 함께 의료전문직업성 함양, 문화적 감수성 개발 등을 제안한다.
이 연구는 외국인 환자 의료사고 예방을 목적으로 국내 의료분쟁 판례 630개를 내용분석(content analysis)으로 분석한 것이다. 주요 연구결과로는 산부인과의 경우가 특징적이었는데, 다른 과목에 비해 인용비율이 낮고, 설명의무 위반에서 문제제기 및 인정비율도 낮았다. 반면 최근의 의료관광으로 외국인 환자 비율이 높은 전공과목인 피부과와 성형외과에서의 설명의무 위반 비율은 높게 나타났다. 전공과목별 판결시, 인용액은 상대적으로 산부인과와 소아과가 높은 반면 외과, 정형외과, 신경외과의 인용액이 내과, 신경과, 정신과에 비해 낮았다. 의료과실이 문제가 되고 인정되는 경우는 수술과 시술, 진단, 환자관찰 영역 순으로 많은데 반면, 의료과실의 인정되는 경우는 환자전원, 의료시설, 환자안전 등에서 높았는데, 특히 환자전원은 의료과실이 인정되는 데 중요한 요소로 밝혀졌다. 최근 의료분쟁에서 설명의무가 점점 중요해지고 있는데 외국인 환자의 경우 문화적, 언어적 차이로 인한 의사소통의 문제를 감안할 때 더욱 중요하다. 위의 연구결과에 기반하여 주요 법적 쟁점으로 설명의무, 전원, 시설 및 환자관리가 도출되었다. 본 연구에서는 외국인 환자를 위한 의료사고 예방 대책으로 중재기관을 통한 해결 등과 같은 비사법적 해결방법 외에 의사-환자 간 효과적인 의사소통 개발과 함께 의료전문직업성 함양, 문화적 감수성 개발 등을 제안한다.
This study was designed to analyze the cases of medical dispute in order to develop the preventive strategies of medical accident and dispute, especially for foreign patients. The method used in the study was content analysis, with 630 domestic precedents. Our observation was distinct particular...
This study was designed to analyze the cases of medical dispute in order to develop the preventive strategies of medical accident and dispute, especially for foreign patients. The method used in the study was content analysis, with 630 domestic precedents. Our observation was distinct particularly in obstetrics and gynecology: the admit rate was lower than that of any other specialties in the judgment while the violation of explanation duty less raised question but was less accepted. On the other hand, the violation of explanation duty became as issue in dermatology and plastic surgery, which are closely related to medical tourism. Obstetrics & gynecology and pediatrics were relatively high in the sum of accept, while surgery, orthopedics, and neurosurgery were much lower than internal medicine, neurology, and psychiatry. The suspect and admission of medical error happened mostly during surgical operation and procedural, diagnosis, and observation of patient in order. Interestingly, patient transfer was relatively important factor in admission of medical error as well. The rate of medical error in admission occurred mostly in management of medical facilities and patient safety. Recently, explanation duty became increasingly important for resolving medical dispute. Considering communication barrier with foreign patients, there should be no exception. Based on the findings, we have extracted several major legal issues as following: explanation duty, patient transfer, and management of facilities and patients. In this study, we therefore suggest effective communication and restoration of trust in patient-doctor relationships, the cultivation of medical professionalism, and the strength of cultural sensitivity, as well as ADR(alternative dispute resolution) as preventive strategies of medical accident for foreign patients.
This study was designed to analyze the cases of medical dispute in order to develop the preventive strategies of medical accident and dispute, especially for foreign patients. The method used in the study was content analysis, with 630 domestic precedents. Our observation was distinct particularly in obstetrics and gynecology: the admit rate was lower than that of any other specialties in the judgment while the violation of explanation duty less raised question but was less accepted. On the other hand, the violation of explanation duty became as issue in dermatology and plastic surgery, which are closely related to medical tourism. Obstetrics & gynecology and pediatrics were relatively high in the sum of accept, while surgery, orthopedics, and neurosurgery were much lower than internal medicine, neurology, and psychiatry. The suspect and admission of medical error happened mostly during surgical operation and procedural, diagnosis, and observation of patient in order. Interestingly, patient transfer was relatively important factor in admission of medical error as well. The rate of medical error in admission occurred mostly in management of medical facilities and patient safety. Recently, explanation duty became increasingly important for resolving medical dispute. Considering communication barrier with foreign patients, there should be no exception. Based on the findings, we have extracted several major legal issues as following: explanation duty, patient transfer, and management of facilities and patients. In this study, we therefore suggest effective communication and restoration of trust in patient-doctor relationships, the cultivation of medical professionalism, and the strength of cultural sensitivity, as well as ADR(alternative dispute resolution) as preventive strategies of medical accident for foreign patients.
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