近五年台灣地區醫療糾紛分析 - 以高訴訟風險科別之醫療訴訟案件為中 心探討
近幾年來，醫療糾紛之案件在新聞播放屢見不鮮，層出不窮。隨著病患權利意識的抬頭
，病患逐漸擺脫以往對於醫師之崇拜服從心態，因此醫師於實施醫療行為時，若有不合 病患或其家屬預期之結果發生，往往引起病患或家屬之質疑，進而引發醫療糾紛，傳統 和諧之醫病關係，已受到明顯之衝擊。
醫療糾紛，不僅僅是病人的夢靨，醫師們更是聞之色變。由於相關資訊及研究不夠且未
被重視，因此隨著醫療糾紛案件一件件被報導，而醫病關係亦日趨緊張。然而台灣各醫 學專科科別之醫療訴訟發生率之概況卻難有詳細資料得知。筆者收集司法院的司法判決 作一統計分析，在深入研習各判決後，以流行病學觀點分析在民事判決及刑事判決各科 在此研究中的訴訟發生率，計畫利用敘述性統計的方式醫師訴訟勝算比、當事人因醫療 行為所發生之結果型態、原告主張醫療過失或誤診之比例及法院判賠償金額之分析…等 相關資訊。
筆者發現民事訴訟中高風險科別的前六大科別為 : 神經外科、急診
醫學科、整形外科、婦產科、骨科及眼科此與美國研究結果是相似的。分析當事人發生
之結果型態觀之，民事及刑事上均已發生死亡及不可逆之傷害占大部份。在當事人聲明 部份共分為醫療過失即誤診兩大類其比例約為三比一。執業醫師在訴訟勝算比例在民事 約為八成而刑事為七成。高訴訟風險科別之平均賠償金額超過一百萬，以急診醫學科最 高。而賠償與否並非以病人發生死亡結果為必要條件。這與一般之觀念有所不同。隨著 醫療糾紛數量的攀升，該議題也越來越重要。
The Analysis of the Information for Medical Legal Problems in the Latest Five Years in Taiwan With High-Risk Specialists
The aim of this work was to find out the top-six medical categories with high-risk in Taiwan b y analyzing the lawsuits of district courts in Taiwan from an epidemiological perspective.
Our research design as a retrospective study to tracking back the medical malpractice cases in Taiwan in the past five years. We try to find out the top-six with high-risk medical categories f rom the incidences of medical disputes.
The characteristics of medical malpractice were also studied. We have collected the lawsuits t ook place in Taiwan as the
database. The studied period was from 2003 to 2007.
Take a view on average annual incidence, the Neurosurgeon,
Emergency medicine, plastic surgery, obstetrics and gynecology,orthopedics, and ophthalmolo gy are the top six medical categories with high risk in Taiwan. In most cases, most the plaintiff s claimed that their medical injuries are caused by the doctor''s ignorance. The av erage rate of doctors who wined the lawsuits is about 0.82. The doctors of top-six
medical categories with high-risk paid over NT.1000, 000 for the cost of damages. The major reasons that plaintiff raised the lawsuits were the occurrences of death or permanent injury of patients. However, the court asserts this result may not be caused by the medical behavior.
