英國醫療風險監管體系的循證評價及其對我國醫療風險管理的啟示——關注病人安全，預防醫療差錯，提高醫療質量_《中國循證醫學雜志》

作者：

馬彬 ¹ ,  楊克虎 ¹ , 劉雅莉 ¹ , 田金徽 ¹ , 張仲男 ¹ , 李幼平 ² , 王莉 ² , 徐莉 ³ , 曹曉源 ³ , 滕永軍 ⁴ , 王羽 ⁵ , 張宗久 ⁵ , 趙明鋼 ⁵ , 陸君 ⁶ , 柳琪林 ⁶

1.蘭州大學循證醫學中心（蘭州 730000）2.四川大學華西醫院中國循證醫學中心（成都 610041）3.甘肅省衛生廳（蘭州 730000）4.蘭州大學第一醫院（蘭州 730000）5.衛生部醫政司（北京 100044）6.中國醫師協會（北京 100054）;

關鍵詞：

醫療風險風險管理醫療差錯病人安全英國

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摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

目的　循證評價英國醫療風險監管經驗，為建立符合我國國情的醫療風險監測預警機制提供依據。
方法　檢索EI、SCI、SSCI、EMbase、SCOPUS（100%包含MEDLINE）和VIP、CNKI等中英文數據庫，同時檢索WHO、英國衛生部等官方網站，語種限定為中文和英文，檢索時間截止2006年1月。全面搜集有關英國醫療風險、病人安全和醫療差錯等方面的相關文獻。
結果　共納入11篇文獻，包括B級9篇，C級2篇。2000年《An Organization with a Memory》報告披露了英國醫療差錯的嚴重程度，同年布萊爾首相發布NHS改革五年計劃。7年間NHS的預算連翻兩番；成立國家病人安全中心（NPSA）；建立國家不良事件和近似差錯分析處理系統；針對主要問題和重要高危領域采取了一系列切實可行的確保病人安全、防范醫療風險、提高醫療質量的措施，有效改善困擾英國政府和民眾多年的問題，如病人候診時間、NHS服務范圍、醫療設備利用率、高危疾病導致的死亡率等，明顯提高了醫療服務質量。
結論　英國的醫療風險監管體系較完善，其取得的經驗和教訓對我國醫療體制的改革、醫療風險的防范、醫療質量的提高，實現人人享有公平、安全的衛生保健目標具有現實的指導和借鑒意義。

引用本文： 馬彬,楊克虎,劉雅莉,田金徽,張仲男,李幼平,王莉,徐莉,曹曉源,滕永軍,王羽,張宗久,趙明鋼,陸君,柳琪林. 英國醫療風險監管體系的循證評價及其對我國醫療風險管理的啟示——關注病人安全，預防醫療差錯，提高醫療質量. 中國循證醫學雜志, 2006, 06(7): 514-522. doi: 復制

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1. 福利國家能否守住自己的“良心”？Available from URL: http://www.people.com.cn/GB/guandian/183/6103/7942/2286805.html.
2. 楊克虎, 馬彬, 田金徽, 等. 美國醫療風險監測預警機制現狀及績效的循證評價. 中國循證醫學雜志, 2006; 6(6): 439～450.
3. 英國醫療保障制度變遷及其啟示. Available from URL: http://www.china-insurance.com/news-center/newslist.asp?id=79122.
4. Whether Welfare country can defends themselves the conscience or not? Available from URL: http://www.people.com.cn/GB/guandian/183/6103/7942/2286805.html.
5. Towse A. Danzon P. Medical negligence and the NHS: An economic analysis. Health Economics, 1999; 8(2): 93-101.
6. An Organisation with a Memory. Report of an Expert Group on Learning from Adverse Events in the NHS Chaired by Chief Medical Officer. Department of Health. 2000. Available from URL: http://www.dh.gov.uk/assetRoot/04/06/50/86/04065086.pdf.
7. Health Care in Canada: The Canadian Institute for Health Information. 9 June 2004.
8. Available from URL: http://www.npsa.nhs.uk/.
9. Building a Safer NHS for Patients: Implementing an organisation with a memory. Department of Health. 2001. Available from URL: http://www.dh.gov.uk/assetRoot/04/05/80/94/04058094.pdf.
10. Yang KH, Ma B, Tian JH, et al. Evidence-based evaluation of American medical risk monitoring and precaution system. Chin J Evid.-based Med, 2006; 6(6): 439-450.
11. Next Step Towards Creating a Safer NHS. Department of Health, Friday 3 August 2001. Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4010827&chk=TzeZXg.
12. Smith G. Assesses the Patient Safety Challenges in the year ahead: NPSA annual review 2004-2005. The National Patient Safety Agency.
13. Chief Executive’s Report to the NHS. Department of Health, December 2005. Available from URL: http://www.dh.gov.uk/assetRoot/04/12/43/02/04124302.pdf.
14. The NHS Improvement Plan: Putting People at the Heart of Public Services. (Executive Summary) Department of Health 2004. Available from URL:http://www.dh.gov.uk/assetRoot/04/08/45/23/04084523.pdf.
15. Hunt LP. Health Minister announces new guidance to reduce medication errors. Department of Health, 3 March 2003.
16. Building a Safer NHS for Patients: Improving Medication Safety. A report by the Chief Pharmaceutical Officer, 2004. Available from URL:http://www.dh.gov.uk/assetRoot/04/08/49/61/04084961.pdf.
17. Ashcroft DM, Quinlan P. Prospective study of the incidence, nature and causes of dispensing errors in community pharmacies. Pharmacoepidemiology and Drug Safety, 2005; 14(5): 327-332.
18. The Quality Interagency Coordination Task Force (QuIC). Doing what counts for patient safety: federal actions to reduce medical errors and their impact (report to the president). February 2000. Available from: URL: http://www.quic.gov/report/errors6.pdf.
19. Tilyard M, Dovey S, Hall K. Avoiding and fixing medical errors in general practice: prevention strategies reported in the Linnaeus Collaboration’s Primary Care International Study of Medical Errors. N Z Med J, 2005; 118(1208): U1264.
20. English medical service safeguard system vicissitude and inspires. Available from: URL: http://www.china-insurance.com/news-center/newslist.asp?id=79122.
21. Public’s priorities are NHS plan priorities. 19 February 2002. Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4013077&chk=ouE2AM.
22. New equality champion for the NHS. 13 October 2004 .Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4091141&chk=nHKml/.
23. ￡8m to develop NHS innovations 1 February 2006. Available from URL: http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4127569&chk=izyp3P.
24. Donaldson L. NHS blame culture is still a killer. 25 March 2005.
25. Available from URL:http://news3.xinhuanet.com/politics/2006-03/18/content_4317180.htm.
26. Investing in primary care: outline of the scheme. Available from: URL: http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/PrimaryCare/InvestingInPrimaryCare/InvestingInPrimaryCareArticle/fs/en?CONTENT_ID=4000560&chk=2gK5tH.
27. Baker R, Norton P, Brown AD. Governments and Patient Safety in Australia, the United Kingdom and the United States: A Review of Policies, Institutional and Funding Frameworks, and Current Initiatives: Final Report, August 2002.
28. World Health Organization. The World Health Report 2005. Available from URL: http://www. who.int/countries/gbr/en/index.html.

《中國循證醫學雜志》

英國醫療風險監管體系的循證評價及其對我國醫療風險管理的啟示——關注病人安全，預防醫療差錯，提高醫療質量

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

《中國循證醫學雜志》

英國醫療風險監管體系的循證評價及其對我國醫療風險管理的啟示——關注病人安全，預防醫療差錯，提高醫療質量

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料