Medical service failure and trend analysis: Evidence from the judgments delivered from district courts

[[abstract]]As the cases of medical malpractice derived from the failure of medical service, both domestically and abroad alike, increased as the days go by. Therefore, how to prevent medical errors is an important issue.Past studies rarely emphasized medical service failure (MSF) based on patients’ viewpoint and also rarely developed prevention strategies based on patients’ perspective. The objective of this research is to analyze the Judicial Legal Information Retrieval System of Medical Malpractice verdict, to discuss the categories of medical failure that took place based on the standpoint of the one who received medical service (namely the plaintiff). In order to have strict accuracy content, this research will be proceeded by adopting two stages model. First stage is to proceed with pilot-study, to analyze 333 cases, and second stage is to collect 998 cases of medical Malpractice from years 1998 to 2014, to adopt content analysis method and utilize content analysis method to categorize and to induce to interpret the reason that causes medical dispute. By the analytical structure, the research analyzes the strategy of four aspects of two dimensional matrices within nature of MSF (namely technical and organizational aspects) and method of MSF (namely direct relationship and indirect relationship) to induce medical MSF incidents into four aspects, and the analysis results in 2887 cases of MSF, 13 items of sub-categories, and 40 items of detailed-categories. The findings are: I. Overall, Regarding to all of the MSF, technical aspect of medical service is higher than organizational aspect of medical service, and all levels Medical institutions also technical aspect of medical service is higher than organizational aspect of medical service,. II. technical aspect of medical service in failure of examination misjudgment, failure during surgical procedure, and failure in diagnosis; technical aspect of medical support and failure during Insufficiency in professional awareness and communication Insufficiency. III. Followed by Three Stages Trend Analysis, failure in technical aspect of medical practice, failure in organizational aspect of medical practice, and failure in organizational aspect of medical support appeared to have trend of decrease progressively, only failure in technical aspect of medical support is increasing progressively by great margin. (IV) After further inspecting 13 items of sub-categories, 6 items of failure appeared to decrease progressively; only treatment, insufficiency in professional awareness; communication during medical treatment, post surgical care of the 4 failure items appeared to have the trend of increasing progressively. The result of this research can be used by the clinical medical staffs as a warning and a prevention of occurrence of MSF during execution of medical practice, and also to provide as a reference for the manager who is drafting related educational courses on the laws of medical care practice, hopefully to reduce the MSF during medical treatment and increase on medical care quality and the safety of the patient