A risk prediction model for medical conflict in emergency departments

Objective: This study aims to identify and analyze patient-related risk factors that lead to medical conflict in emergency departments and to build a patient-related risk prediction model, which can serve as a tool for medical professionals to prevent medical conflict in emergency departments. Background: At present, the research on the countermeasures of medical conflict in emergency departments mainly focuses on post-event coping strategies and rarely addresses the early warning of conflict occurrence. Methods: Through a retrospective analysis of medical conflict events in the emergency pre-examination and rescue areas, 105 conflict cases and 525 non-conflict cases were collected. Univariate analysis, neural network analysis and support vector machine (SVM) were performed to analyze patient-related risk factors in medical conflict, thereby constructing a prediction model. Results: Neural network analysis yielded an accuracy of 96.4% (sensitivity: 91.2%, specificity: 97.7%) and an area under the ROC curve of 0.966. The order of importance of risk factors included in the prediction model is in descending order of importance: waiting time; patient non-compliance to the treatment process; patient's skepticism toward care; number of caregivers; medical professionals' failure to respond to patients' needs; and history of psychosomatic diseases. The SVM utilizing 10-fold cross-validation demonstrated an accuracy of 96.4% in independent testing samples, with a sensitivity of 91.2% and a specificity of 97.2%. Conclusion: This model may accurately predict the occurrence of medical conflicts in emergency departments with high accuracy, providing a theoretical basis for preventing medical conflicts. Implications for management: We have developed a risk prediction model to help emergency medical professionals identify factors that may contribute to preventing medical conflict, reducing conflict events, and enhancing the doctor-patient relationship.