目的：分析675例医疗纠纷案件，提出持续改进医疗质量的对策建议。方法：收集南京市2022年经某医疗责任险经办机构处理结案的675例医疗纠纷案件，分析纠纷案件特点、高发科室、医方过失原因和违反的医疗核心制度，发现医疗机构在诊疗过程中的高风险因素。结果：三级医疗机构年龄大、住院、手术的患者是医疗纠纷高发人群，妇产科、骨科、普外科、急诊科、心胸外科等科室是医疗纠纷的高发科室，手术/操作相关过失是医疗纠纷产生的主要原因，存在会诊制度、病历管理制度等医疗核心制度执行不力的情况。结论：医疗机构应重点关注医疗纠纷发生的高风险因素，针对高风险因素，建立持续加强医疗技术和改进医疗质量与安全的全面质量管理机制。

Objective：To analyze 675 medical malpractice cases and provide countermeasures for continuous improvement of medical quality. Methods：The information of 675 medical malpractice cases handled by a medical liability insurance underwriting agency in Nanjing in 2022 was collected. The characteristics，high-risk departments，medical staff's negligence reasons，and violation of medical core systems in the treatment process were analyzed to identify high-risk factors in the medical institutions' treatment process. Results：The study found that elderly patients，inpatients，and surgical patients in tertiary medical institutions were high-risk groups for medical disputes，and obstetrics and gynecology，orthopedics，general surgery，emergency department，and cardiothoracic surgery were high-risk departments. Operating/procedure-related negligence was the main reason for medical disputes，and there were problems with the implementation of core medical systems such as consultation system and medical record management system. Conclusion：Medical institutions should focus on high-risk factors in medical disputes and establish a comprehensive quality management mechanism for continuous improvement of medical technology and medical quality and safety.