医患利益保护下的医疗纠纷赔偿

由于公民法律意识和服务意识的提高,医疗新技术的开展和应用,部分医护人员职业道德的下降,一些新闻媒体的片面报导,以及法院对医疗纠纷案高额赔偿的判决和判决的随意性等因素,近年来,医疗投诉和法院受理的医疗纠纷案逐年上升,且患方要求赔偿的标的额也越来越大,医患双方赔偿矛盾日趋激化.     

医患利益保护下的医疗纠纷赔偿

由于公民法律意识和服务意识的提高 ,医疗新技术的开展和应用 ,部分医护人员职业道德的下降 ,一些新闻媒体的片面报导 ,以及法院对医疗纠纷案高额赔偿的判决和判决的随意性等因素 ,近年来 ,医疗投诉和法院受理的医疗纠纷案逐年上升 ,且患方要求赔偿的标的额也越来越大 ,医患双方赔偿矛盾日趋激化。一、医疗赔偿中医患双方利益的矛盾冲突医疗赔偿中的矛盾冲突就是医患双方利益的冲突。1 987年国务院制定的《医疗事故处理办法》 (下称《办法》) ,在一段时间内对医疗纠纷的处理起了不可磨灭的作用。然而 ,随着社会的发展 ,物价的上涨 ,人民生活…     

Assaultive behavior in state psychiatric hospitals: differences between forensic and nonforensic patients

Forensic patients are occupying an increasingly large number of beds in state psychiatric hospitals. The presence of these mentally ill offenders has raised concerns about the risk they present to nonforensic patients. This study compared the rate of assaults and factors associated with assaultive behavior among 308 nonforensic patients and two groups of forensic patients including 469 patients found not guilty by reason of insanity and 76 pretrial patients. Consistent with other studies, nonforensic patients had higher rates of assaults than either group of forensic patients. However, being a forensic patient did not affect the odds of assault when controlling for the effects of demographic and clinical variables in a multivariate logistic regression analysis. Factors associated with assaults in each of the three patient groups were identified using multivariate analyses. Implications are presented for treatment of assaultive behavior, mixing of forensic and nonforensic patients within state hospitals, forensic release policies, and future research.     

The relationship between the detection of acquisitive crime by forensic science and drug-dependent offenders

Drug- and nondrug-related acquisitive crime offences such as burglary, theft, and motor vehicle theft, were compared to assess whether drug abusers were more likely to be apprehended via forensic science techniques. Data were all acquisitive offences committed over a 6-year period within a police force area in England. Drug-dependent offenders committed a wider range of offence types than nondependent offenders, and they were significantly more likely to be detected via their DNA or fingerprints (p < 0.01). A logistic regression (n > 14,000) revealed a number of predictors that influence the detection of the crime by forensic techniques. The results indicate that a number of these predictors are of statistical significance; the most significant of these being drug use by the offender with sex, ethnicity, and employment status also being relevant. Age of the offender and number of offences committed were found not to be significant. Of the four hypotheses considered to explain this, the most likely was thought to be the physical and mental impact of drug use on crime scene behavior. Consideration is given to the disciplines of forensic science and forensic psychology working closely together to distinguish factors that influence crime scene behavior.     

Organizational corruption by public hospitals in China

This article studies the rise of organizational corruption by public hospitals in China since the 1990s and its impacts. Organizational corruption refers to the exploitation of public authority by a government agency for its monetary or material gains. This article argues that a combination of three major factors contributed to the rise of organizational corruption by public hospitals. First, the Chinese government substantially reduced its financial commitment to the health sector since the mid-1980s. To compensate for the retrenchment of government health outlays, public hospitals are authorized to earn revenue, keep and use all budgetary surpluses. This policy provided numerous opportunities and incentives for hospitals to engage in corruption. The second factor concerns the excessive and chaotic development of the pharmaceutical sector. Intense competition has prompted many drug firms to offer bribes to public hospitals so that their products would be purchased. Finally, the state regulatory infrastructure has failed to check the spread of corrupt practices. The study raised two broader implications. First, it highlights the pitfall of retrenchment of government outlays and the subsequent policy of allowing state agencies to generate, retain and use the revenue, in the absence of an effective regulatory infrastructure. Second, the prevalence of organizational corruption indicates that the nature of public hospitals in China has been transformed. Instead of providing efficient, safe and affordable treatment for patients, many public hospitals have engaged in predatory behavior that is harmful to patients’ health.     

Structural determinants of union activity in hospitals

This study uses national data from the American Hospital Association and the National Labor Relations Board in a multivariate framework to assess the impact of various structural factors on union activity in hospitals. The theoretical framework includes both management and union perspectives in evaluating (1) whether the hospital had a signed collective-bargaining contract in 1980; (2) whether a union election had been held; and (3) whether the union won the election. The results indicate that certain structural characteristics (hospital size, ownership, teaching status, and location) have had a significant impact on union activity in hospitals, while other characteristics (third-party reimbursement and area factors) have not. The results also show that prospective reimbursement has a positive impact on union activity.     

认真对待利益——利益的行政法意义

在社会关系日益复杂、权利概念的严格性日渐丧失的情况下 ,利益在西方国家的行政法中勃兴 ,其法律地位逐渐被承认 ,并对行政法提出了新的挑战 ,推动了现代行政法的产生。受传统文化和现实情况多种因素的影响 ,利益在我国行政法中被漠视 ,或者没有以其应有的面貌出现。正在进行社会主义法治建设又一贯缺乏权利意识的中国 ,行政法必须考虑现实需求 ,认真对待权利的同时 ,认真对待利益     

Treating Life Literally

This essay is a study of three texts written by the psychoanalyst Wulf Sachs. These texts hold an important lesson about the psychoanalytic turn in jurisprudence. Their attempt to extend psychoanalysis’s frontiers to fight the legalization of racism in pre-apartheid South Africa recoils upon itself, stripping self-evidence from the singular constellation of law, life, language, and sovereignty psychoanalysis derives from ancient and modern tragedy and formalizes into a discipline. Even as Sachs’s trilogy turns to psychoanalysis to critique the legalization of racism, it also points to the limits of psychoanalysis itself as a paradigm for the study of law.

The profits of not-for-profit hospitals

This paper explores the profits of not-for-profit (NFP) hospitals and identifies the factors that determine whether such profits are adequate. A model which relates hospital charges to surpluses is used to derive NFP surplus from gross patient charges and operating costs. This is done to identify the items contributing to surpluses and to explore the dispersion of NFP surpluses. We first discuss why the literature is relatively silent on NFP profitability. We then present the model and use Tennessee hospital data to identify how its components vary by hospital type and through time. The dispersion of surpluses among NFPs is then examined. We next propose three rate of return measures of profitability and use these to relate NFP profits to select characteristics of hospitals and their environments. Several alternative profit levels of NFP are discussed, and the factors that are relevant to the issue of determining the adequate level of profit are identified. The paper ends with a plea for better data on NFP profits.     

Medicaid reimbursement of teaching hospitals

This paper examines current Medicaid policies on the reimbursement of hospitals' medical education expenses. These policies are of interest because of the pressure on Medicaid programs to reduce expenditures. Data for the paper come mainly from two sources: a survey of Medicaid programs and a survey of teaching hospitals. Teaching hospitals receive a disproportionate share, nearly 70 percent in 1978, of Medicaid short-term hospital payments. Nevertheless, most Medicaid programs either have no explicit policies in this area or have not acted aggressively to limit reimbursement of hospitals' teaching expenses. Revenues from Medicaid are most important to public teaching hospitals. Thus, across-the-board reductions in Medicaid's reimbursement of teaching expenses would most severely affect public institutions, many of which already face cuts in their local government appropriations. Savings to Medicaid would also be short-lived, since teaching hospitals would have the incentive to reduce teaching program size and substitute reimbursable personnel (nurses and staff physicians) for residents.     

Suicides in hospitals of Vienna (author's transl)]

An analysis of the autopsies ordered by the Viennese Forensic and Health Authorities between 1967 and 1976 has shown that 2.3% of all suicides were committed in hospitals. Two thirds of the 77 examined cases were carried out by males. Thirty-five patients were in stationary psychiatric treatment; their average age was 50.7 years. In all other kinds of hospitals 42 (mostly male) patients committed suicide at an average age of 65.3 years. Preferred methods of performance were jump and fall from height (44.1%) and hanging (40.3%). Rare methods used were one case of abdominal incisions (harakiri), one self-strangulation, and one case of suffociation in plastic bags. The act was usually accomplished early in the morning or in the late afternoon. Among the suicidal patients who were hospitalized because of organic diseases those with malignant neoplasms [18] and cardiovascular diseases [12] were predominant. Also taking the suicides outside hospitals into consideration the numerical ratio between natural deaths due to cancer and the suicides of cancer patients is about 1:1,000. Amont the suicides in psychiatric institutions schizophrenics [11] and endogenous depressives [7] were the most numerous. In 4 cases the suicide was preceded by acts of injury or homicide.