日本產科腦性麻痺補償制度—提高周產期照護品質及安全並減輕衝突的新制度

The Japan Obstetric Compensation System for Cerebral Palsy - Novel system to improve quality and safety in perinatal care and mitigate conflict

日本產科腦性麻痺補償制度（Japan Obstetric Compensation System for Cerebral Palsy，以下簡稱JOCS-CP），在2009年正式施行，是由財團法人日本醫療機能評價機構（Japan Council for Quality Health Care，以下簡稱JQ）與醫療專業組織、病人和家屬團體、保險公司和政府等利益相關者密切合作，以解決產科醫生不足和訴訟案件不斷增加的醫療糾紛問題。補償制度透過與JQ簽訂合約的保險公司提供補償保險服務。JOCS-CP制度施行後獲得很大的成就，例如：降低產科訴訟案件數量及提升周產期的照護品質。該制度在腦性麻痺補償已成功擴大涵蓋範圍兩次。本文描述該制度的概要、現況以及挑戰。

 

The Japan Obstetric Compensation System for Cerebral Palsy (JOCS-CP) was launched in 2009 by the Japan Council for Quality Health Care (JQ) in close cooperation with such stakeholders as professional societies, patient and family group, insurance firm and the government to address shortage of obstetricians and rising disputes including lawsuit[1,2]. Private insurance accounts for financial transaction in the system. The JOCS-CP has given rise to enormous achievements such as rapid decrease in the number of lawsuit statistics and quality improvement of perinatal care. The system has successfully expanded twice in terms of coverage of CP. Here, in this article, outline and current status of the system and challenges are described.