Abstract
BackgroundMedical litigation represents a growing cost to healthcare systems. Mediation, arbitration, and other alternative dispute resolution (ADR) methods are increasingly used to help solve the disputes and improve healthcare satisfaction. In China, the increasing number of medical disputes has contributed to concern for the safety of physicians and mistrust between physician and patients resulting in ADR processes being established in several provinces in recent years. Our aim was to describe and explain the impact of this new mediation process in the Chinese healthcare system.MethodsOur study investigated mediation practices in China using case-level data from 5614 mediation records in Guangdong Province between 2013 and 2015. We investigated how the resolution success as well as the compensations are associated with the case characteristics using regression analysis.ResultsAmong the cases analyzed, 1995 (41%) were solved with agreement through mediation, 1030 were closed by reconciliation, 559 were closed by referring to court and 1017 cases were withdrawn after mediation. Five hundred five Yinao cases were solved with the help of mediators on the spot. We find that mediation solved about 90% of medical disputes under present mechanisms, while more police support is needed to cope with Yinao. The average compensation of mediation is CNY60,200 and average length of mediation is 87 days. Longer time taken to reach resolution and more money claimed by patients are associated with lower resolution success rate (p < 0.01) and higher compensation levels (p < 0.01).ConclusionOur results show the performance of mediation mechanisms in China to help solve medical disputes. ADR plays a role in reducing the need for initiating litigation and may ultimately increase satisfaction with the healthcare system.
Highlights
Medical litigation represents a growing cost to healthcare systems
Guangdong province in China had a Gross Domestic Product (GDP) of 8.09 trillion China Yuan (CNY) and a population of 110 million people in 2016, making it the largest province measured by wealth and population [23]
We have investigated the relationship of mediation success and compensation amount with duration of the case, first claim by patients, age of patients, controlling causes of medical disputes, hospital classification, consequences and year effects
Summary
Medical litigation represents a growing cost to healthcare systems. Mediation, arbitration, and other alternative dispute resolution (ADR) methods are increasingly used to help solve the disputes and improve healthcare satisfaction. A number of organizational reforms on the supply-side have been implemented to improve the quality and efficiency of Chinese healthcare delivery [1, 2] One particular case of hospital violence, commonly known as Yinao in Chinese, describes organized unemployed gangs who are paid by patient families to create medical disturbances to get compensation for actual or perceived malpractice from hospitals [8]. Through this illegal approach, patients in dispute with hospitals usually expect to get higher compensation compared to other approaches [9]. With the hospital being surrounded by Yinao gangs, hospital operations such as diagnosis and treatment are disrupted and hospital staff, equipment and facilities are at risk
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