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南京医科大学学报（社会科学版）京医科大学学报（社会科学版）
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Journal of Nanjing Medical University（Social Sciences）of Nanjing Medical University（Social Sciences） 2026年6月
Journal

Pathway selection for medical malpractice evaluation: a dual⁃track

operation or a unified model

3
1
2
ZHANG Shicheng ，JI Baoyi ，ZHU Zhiguang ，JIANG Tao 2，3
1. Academic Affairs Department/Continuing Medical Education Department，2. Technical Appraisal Office for Medical Accidents，
3. General Office，Nanjing Medical Association，Nanjing 210003，China
Abstract：As a pivotal component of the governance system for medical damage liability disputes，the
institutional construction of medical malpractice evaluation exerts a far⁃reaching influence on the high⁃efficiency
governance in the medical field. Therefore，this study systematically examines two developmental phases that
medical malpractice evaluation has undergone since the 21st century from the perspective of institutional change
theory，namely the dual⁃track operation phase and the dual⁃track integration phase. It conducts an in⁃depth
analysis of local governance patterns and their practical dilemmas within the context of phased institutional
paradigms. This study further offers theoretical interpretations and changes management analysis on this
institutional transition. The purpose is to explain the institutional genesis of medical malpractice evaluation，
thereby offering historical references for subsequent institutional reforms and innovations in the field.
Key words：medical malpractice evaluation；institutional change；dual ⁃ track operation；dual ⁃ track
integration；practical reflection