臺北市醫療爭議解決途徑之分析

Objectives: Within 2001-2005, Taipei City Government Department of Health (TCGDOH) received 889 medical dispute complaints, of which 166 filed for their mediation. This study aims at analyzing the patterns of mediation operated by the health authorities and litigation in Taipei city. Methods: This study is a retrospective longitudinal secondary data analyses. The data came from the mediation data base of the TCGDOH and the court judgment database of the Judicial Yuan within 2001-2005. Results: Of the mediation cases, 86.1% are directly medical related in terms of causes; 30.1% concern the specialty of internal medicine, 24.5% obstetrics and gynecology, 9.6% surgery and 9.6% plastic surgery respectively. Analyzing the court cases transpired between 1998 and 2000, of those filed in the civil docket, 22.2% appealed the district courts' decisions and none appealed the appellate court's decisions; whereas in the criminal docket, 44.1% went on to the appellate court and 26.7% to the supreme court. Conclusions: Both the utilization rate and success rate of TCGDOH mediation are not high. On the other hand, most patients and their families cannot persist through the appellate process and their chances of winning are also low. Increase the general public's acceptance of administrative mediation could potentially create an important avenue to mitigate the damage caused by medical disputes.