急診設置專責一般醫療主治醫師，可以減少醫療糾紛的發生

Hospitalists in hopital emergency department help decrease the number of medical malpractices

目的：設置急診專責一般醫療主治醫師，期望能減少醫療糾紛的發生。方法：蒐集南部某醫學中心成立專責一般醫療主治醫師（2012年8月）前後各15個月內的急診醫療糾紛案件數目。利用卡方檢定驗證急診成立特殊醫療單位，是否可以減少醫療糾紛的案件。結果：專責一般醫療主治醫師成立前後的醫療糾紛案件數分別為28及14件。醫療糾紛發生率從0.015%下降為0.008%。利用兩獨立母體的比率差之Z檢定，標準誤為0.00036，Z=19.22，顯示兩樣本差異達統計顯著，表示成立特殊醫療單位於急診照護病人，確實可以減少醫療糾紛的發生。結論：本研究驗證了急診設置專責一般醫療主治醫師，可以減少醫療糾紛的發生及案件，並提供一項針對醫院制度改變的作法，期盼改善醫療環境，節省健保資源，同時減少醫療糾紛。

Objective: To investigate whether the hospitalists in a hospital emergency department(ER) can reduce the number of medical malpractices. Methods: The number of medical malpractices in ER of a medical center in southern Taiwan was collected within 15-months period before and after staffing hospitalists since August 2012. We utilized Chi-squared test to verify whether the hospitalists in ER can reduce the number of medical malpractices. Results: The number of medical malpractices in ER before and after staffing hospitalists was 28 and 14, respectively. Its incidence rate was 1.2 cases per ten thousand visitors during the study period. The incidence rate of medical malpractices before and after staffing hospitalist was 1.5 cases per ten thousand visitors and 0.8 cases per ten thousand visitors, respectively. This result shows that the number of medical malpractices was significantly decreased using the Chi-squared test to verify. Conclusion: We verified and proved that the number of medical malpractices was significantly decreased after staffing hospitalists in ER for emergent medical aids. The outcomes may provide other hospitals with a way of managing and reducing medical malpractice to refine the medical environment, to save healthcare resources, and to reduce the number of malpractices, which can be focused on making improvements in future.