Abstract: In medical disputes, medical damage appraisal plays a crucial role in determining such aspects as the fault of medical behaviors, causation, scope of damage compensation, and liability allocation. However, predicaments such as difficulties in submitting cases for appraisal and long duration of appraisal have become prominent issues restricting the quality and efficiency of the trial of medical dispute cases in courts. Through an empirical analysis of medical dispute cases in the two-level courts of City H since 2024, it is found that medical damage appraisal has problems including an imbalance between supply and demand for appraisal, difficulties in initiating appraisal procedures, long appraisal cycles, and widespread disputes over appraisal conclusions. The root causes of the difficulties in submitting cases for medical damage appraisal lie in the non-smooth operation of the system, insufficient resource guarantee, and the failure to effectively establish a social trust mechanism. Therefore, it is necessary to take multiple measures in terms of integrating resources, improving systems, strengthening guarantees, tightening supervision, and diversifying dispute resolution, so as to solve the problem of difficulties in submitting cases for medical damage appraisal, enhance the quality and efficiency of the trial of medical dispute cases, and build a scientific and efficient medical damage appraisal system.

Key words: medical damage appraisal, difficulty in submitting for appraisal, dual-track system, judicial quality and efficiency

摘要： 在医疗纠纷中，医疗损害鉴定结果对于医疗行为过错、因果关系、损害赔偿范围、责任分配等认定具有关键作用。但医疗损害鉴定“送鉴难”、鉴定时间长等困境已成为当前制约法院医疗纠纷案件审理质效的短板。通过对2024年以来H市两级人民法院医疗纠纷案件的实证分析可以发现，医疗损害鉴定存在鉴定供需失衡、鉴定程序启动难、鉴定周期长、鉴定意见争议大等方面的问题。医疗损害鉴定“送鉴难”的根源在于制度运行不畅、资源保障力度不够和社会信任机制尚未完全建立等。对此，建议从整合资源、完善制度、加强保障、强化监管、多元解纷等方面综合施策，构建科学高效的医疗损害鉴定体系，破解医疗损害鉴定送鉴难题，促进医疗纠纷案件审判质效提升。

关键词: 医疗损害鉴定, 送鉴难, 双轨制, 审判质效