摘要
目的对中医诊所执业各环节要素进行风险评估,探讨关键风险要素,准确把握中医诊所监督执法的要点和难点,针对高风险指标作为亟需降低或消除的风险因素,加强监督管理,降低其执业风险。方法2022年5-10月,根据中医诊所执业规范要求,参考监督资料,制定中医诊所执业各环节风险指标评估表,由15名中医执业相关管理专家对每一项风险指标的发生可能性、风险危害的严重性、风险预防或发生时处理措施程度进行赋分风险评估,计算风险优先系数,并按照百分位数的不同对风险因素进行风险等级评估。结果对30个执业风险要素指标通过百分位等级划分低风险3个、中低风险12个、中风险8个、中高风险4个、高风险3个;其中高风险及中高风险环节要素指标共7项,按分值从高到低依次为超执业范围、中医创伤性或侵入性的技术不规范、未落实医疗质量安全、未登记备案、雇佣医托招揽病人、医师执业资质不符合、未落实隔离控制及上报。结论中医诊所执业中存在不同程度执业风险,应加强培训、指导、告知、提醒、警示,提高识别、研判处理风险能力,把握切入点开展重点监督和综合监管及信息化监管,并对高风险因素进行全方位重点评估,保障中医医疗安全。
Objective To assess the risk of various elements in the practice of Traditional Chinese Medicine(TCM)clinics,explore key risk elements,accurately grasp the key points and difficulties of supervision and law enforcement in TCM clinics,and take high-risk indicators as risk factors that urgently need to be reduced or eliminated,so as to strengthen supervision and management to reduce their practice risks.Methods From May to October 2022,in accordance with the requirements of TCM clinic practice standards and reference to supervision materials,a risk indicator evaluation table for each link of TCM clinic practice was developed.15 management experts related to TCM practice were assigned points for risk assessment on the likelihood of occurrence,severity of risk hazards,and degree of risk prevention or treatment measures when each risk indicator,calculate the risk priority coefficient,and assess the risk level of risk factors according to the different quantile of percentiles.Results 30 practicing risk factor indicators were divided into 3 low risk,12 medium low risk,8 medium risk,4 medium high risk,and 3 high risk through percentile ranking;the risk link elements were classified into seven indicators,including high risk and medium high risk link elements.According to the score from high to low,they were in the order of exceeding the scope of practice,trauma-tic or invasive technical irregularities in traditional Chinese medicine,failure to implement medical quality and safety,failure to register for filing,employment of medical care to recruit patients,and noncompliance of doctors'professional qualifications isolation control and reporting were not implemented.Conclusion There are varying degrees of professional risks in the practice of TCM clinics,and training,guidance,notification,reminders,and warnings should be streng-thened to improve the ability to identify,analyze,and handle risks.Key supervision,comprehensive supervision,and information technology supervision should be carried out to grasp the entry point,and comprehensive evaluation of high-risk factors should be conducted to ensure the safety of TCM.
作者
祝秀英
刘艳
吴梦安
ZHU Xiuying;LIU Yan;WU Meng'an(Shanghai Pudong New Area Health Supervision Institute Commission,Shanghai,200135,China)
出处
《中国社会医学杂志》
2025年第2期246-250,共5页
Chinese Journal of Social Medicine
基金
浦东新区卫生健康委员会卫生计生科研项目(PW2020A-13)
浦东新区卫生和计划生育委员会学科带头人培养计划(PWRd2018-19)。
关键词
中医诊所
执业风险
风险要素
评估
TCM clinics
Professional risks
Risk factors
Evaluation
