目的 了解河南省医疗纠纷现状，为缓解医患矛盾，减少医疗纠纷提供政策依据。方法 随机抽取100家各级医疗卫生机构，采用集中填答法进行问卷调查。 结果 2012—2014年平均每家医院医疗纠纷数达28.6件，每万例次业务量纠纷数0.943件，每百名医师纠纷数4.765件；外科、妇科及儿科是纠纷发生率前3位的科室；医务人员技术问题导致的医疗纠纷占27.9%，医德医风问题占10.5%，患者要求不合理占46.0%；多重线性回归分析显示医院平均年出院患者(t＝7.987 ,P＜0.001)、临床医师床位比(t＝-2.476 ,P=0.015)与护理人员床位比 (t＝-6.426,P＜0.001)对医疗纠纷数的影响差异有统计学意义；平均每家医院通过医患协商途径处理医疗纠纷27.5件，司法途径10.5件，医调委解决9.5件；医患协商平均耗时1.2月，平均费用76 927.4元；医调委途径平均耗时0.6月，平均费用36 141.1元；司法途径平均耗时6.3月，平均费用58 942.7 元。 结论 针对高发科室实施预警防范，根据纠纷特点选择适宜的处理方式；积极实施分级诊疗、双向转诊制度，缓解就医压力；进一步推进公立医院改革，破除逐利机制，构建和谐的医疗环境。

Objective To understand the present situation of medical disputes in Henan Province, in order to provide policy basis for alleviating the doctor-patient conflicts and reducing medical disputes. Methods Concentrated orientation method was adopted to improve the questionnaire by a random sample of 100 medical and health institutions at various levels. Results From 2012 to 2014, the average number of medical disputes was 28.6 in each hospital, 0.943 per million of cases several business disputes, and 4.765 per hundred of physicians. The top three departments of disputes were surgery, gynecology and pediatrics. Medical disputes were caused by medical staff technical problems (27.9%), the problem of medical ethics (10.5%), and unreasonable patient demand(46.0%). Multiple linear regression analysis showed that the average annual discharge from the hospital patients (t＝ 7.987, P ＜ 0.001), "clinicians beds" (t = 2.476, P = 2.476) and "nursing beds" (t = 6.426, P < 0.001) influence on the number of medical disputes difference was statistically significant. On average, 27.5 medical disputes were dealt with by medical association in every hospital, 10.5 by judicial way and 9.5 by the medical committee. Doctor-patient consultation took 1.2 months on average and the average cost of 76 927.4 yuan. Medical dispute mediation committee approach took 0.6 months on average and the average cost of 36 141.1 yuan. Justice access took 6.3 months on average, the average cost 58 942.7 yuan. Conclusion Warning and prevention should be taken to high-risk departments. Grading diagnosis and treatment and two-way referral system should be actively strengthened. The reform of public hospitals should be further promoted to break profit mechanism and construct harmonious medical environment.