基于不良事件管理的医疗纠纷列线图预测模型构建及评价

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中图分类号：R197.323 文献标识码：A

Construction and Evaluationof a NomogramPrediction ModelforMedical Disputes BasedonAdverseEventsManagement/WANG Tongzhou，LIN Haitao，ZHOU Jin，et al.//Chinese Health Quality Management，2025，32（4）：74－78

Abstract ObjectiveTo analyze the influencing factors of medical disputes in hospitals based on medical quality and safety adverse events，construct a nomogram prediction model for medical disputes risk，andevaluate its performance. MethodsA total of 5O3 adverse events from a tertiary hospital in Jiangsu Province between January 202O and December 2O23 were selected as the study subjects.Univariate and multivariate logistic regresson analyses were used to identifythe influencing factors of medical disputes.A nomogram prediction model for medical disputes risk was established.The diagnostic performance and calibration of the nomogram model were evaluated using receiver operating characteristic （ROC）curve and calibration curve，while decision curve analysis was employed to assssits utility.Results Male healthcare workers，patient age ⩽ 4 0 years，patient occupation as farmer，non-critical illness severity，and adverse events of levels one to three were independent risk factors for medical disputes （all P<0 . 0 5 ）. The area under the ROC curve for the nomogram prediction model was O.888，with an H - L test P -value of 0.059. The Index for internalvalidation of thecalibrationcurve wasO.897，and the meanabsolute error wasO.O21.The net benefitof the decision curve was high when the threshold probability ranged from O.O2 toO.80.ConclusionThe nomogram prediction model for medical disputes risk constructed based on medical adverse events management demonstrates good predictive performance and clinical applicability， providing insights for medical quality and safety management.

Key words Medical Disputes; Adverse Events; Nomogram;Prediction Model First-author's address Jiangsu Cancer Hospital （Jiangsu Province Hospital Afiliated to Nanjing Medical University/Jiangsu Cancer Center） ，Nanjing，Jiangsu，21oooo，China

医疗质量安全不良事件是指在医疗机构内被工作人员主动发现的，或患者在接受诊疗服务过程中出现的，除患者自身疾病自然过程外的各种因素所致的不安全隐患或造成后果的负性事件[1]。（剩余6076字）