• 1.蘭州大學(xué)循證醫(yī)學(xué)中心（蘭州 730000）2.四川大學(xué)華西醫(yī)院中國循證醫(yī)學(xué)中心（成都 610041）3.甘肅省衛(wèi)生廳（蘭州 730000）4.蘭州大學(xué)第一醫(yī)院（蘭州 730000）5.衛(wèi)生部醫(yī)政司（北京 100044）6.中國醫(yī)師協(xié)會（北京 100054）;

目的 　循證評價英國醫(yī)療風(fēng)險監(jiān)管經(jīng)驗(yàn)，為建立符合我國國情的醫(yī)療風(fēng)險監(jiān)測預(yù)警機(jī)制提供依據(jù)。
方法 　檢索EI、SCI、SSCI、EMbase、SCOPUS（100%包含MEDLINE）和VIP、CNKI等中英文數(shù)據(jù)庫，同時檢索WHO、英國衛(wèi)生部等官方網(wǎng)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(guān)英國醫(yī)療風(fēng)險、病人安全和醫(yī)療差錯等方面的相關(guān)文獻(xiàn)。
結(jié)果 　共納入11篇文獻(xiàn)，包括B級9篇，C級2篇。2000年《An Organization with a Memory》報(bào)告披露了英國醫(yī)療差錯的嚴(yán)重程度，同年布萊爾首相發(fā)布NHS改革五年計(jì)劃。7年間NHS的預(yù)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(tǒng)；針對主要問題和重要高危領(lǐng)域采取了一系列切實(shí)可行的確保病人安全、防范醫(yī)療風(fēng)險、提高醫(yī)療質(zhì)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(wù)范圍、醫(yī)療設(shè)備利用率、高危疾病導(dǎo)致的死亡率等，明顯提高了醫(yī)療服務(wù)質(zhì)量。
結(jié)論 　英國的醫(yī)療風(fēng)險監(jiān)管體系較完善，其取得的經(jīng)驗(yàn)和教訓(xùn)對我國醫(yī)療體制的改革、醫(yī)療風(fēng)險的防范、醫(yī)療質(zhì)量的提高，實(shí)現(xiàn)人人享有公平、安全的衛(wèi)生保健目標(biāo)具有現(xiàn)實(shí)的指導(dǎo)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(yī)療風(fēng)險監(jiān)管體系的循證評價及其對我國醫(yī)療風(fēng)險管理的啟示——關(guān)注病人安全，預(yù)防醫(yī)療差錯，提高醫(yī)療質(zhì)量. 中國循證醫(yī)學(xué)雜志, 2006, 06(7): 514-522. doi: 復(fù)制

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(yī)療風(fēng)險監(jiān)測預(yù)警機(jī)制現(xiàn)狀及績效的循證評價. 中國循證醫(yī)學(xué)雜志, 2006; 6(6): 439～450.
3. 英國醫(yī)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.
  1. 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. 2. 楊克虎, 馬彬, 田金徽, 等. 美國醫(yī)療風(fēng)險監(jiān)測預(yù)警機(jī)制現(xiàn)狀及績效的循證評價. 中國循證醫(yī)學(xué)雜志, 2006; 6(6): 439～450.
  3. 3. 英國醫(yī)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. 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. 5. Towse A. Danzon P. Medical negligence and the NHS: An economic analysis. Health Economics, 1999; 8(2): 93-101.
  6. 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. 7. Health Care in Canada: The Canadian Institute for Health Information. 9 June 2004.
  8. 8. Available from URL: http://www.npsa.nhs.uk/.
  9. 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. 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. 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. 12. Smith G. Assesses the Patient Safety Challenges in the year ahead: NPSA annual review 2004-2005. The National Patient Safety Agency.
  13. 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. 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. 15. Hunt LP. Health Minister announces new guidance to reduce medication errors. Department of Health, 3 March 2003.
  16. 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. 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. 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. 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. 20. English medical service safeguard system vicissitude and inspires. Available from: URL: http://www.china-insurance.com/news-center/newslist.asp?id=79122.
  21. 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. 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. 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. 24. Donaldson L. NHS blame culture is still a killer. 25 March 2005.
  25. 25. Available from URL:http://news3.xinhuanet.com/politics/2006-03/18/content_4317180.htm.
  26. 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. 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. 28. World Health Organization. The World Health Report 2005. Available from URL: http://www. who.int/countries/gbr/en/index.html.