对医疗事故的担忧对剖宫产率的影响。

The impact of malpractice fears on cesarean section rates.

作者信息

Dubay L, Kaestner R, Waidmann T

机构信息

Health Policy Center, Urban Institute, Washington, DC 20037, USA.

出版信息

J Health Econ. 1999 Aug;18(4):491-522. doi: 10.1016/s0167-6296(99)00004-1.

DOI:10.1016/s0167-6296(99)00004-1

PMID:10539619

Abstract

A longstanding issue in the health care industry is whether physicians' malpractice fears lead to defensive medicine. We use national birth certificate data from 1990 through 1992 to conduct a county fixed-effects analysis of the impact of malpractice claims risk on cesarean-section rates and infant health. Malpractice claims risk is measured by obstetricians' malpractice premiums. The study provides evidence that physicians practice defensive medicine in obstetrics but that the impact of increased cesarean sections that results from malpractice fears on total obstetric care costs is small. The study also finds that physicians' defensive response varies with the socioeconomic status of the mother.

摘要

医疗行业长期存在的一个问题是，医生对医疗事故的担忧是否会导致防御性医疗行为。我们使用1990年至1992年的全国出生证明数据，对医疗事故索赔风险对剖宫产率和婴儿健康的影响进行县级固定效应分析。医疗事故索赔风险通过产科医生的医疗事故保险费来衡量。该研究表明，医生在产科会采取防御性医疗行为，但因对医疗事故的担忧而增加剖宫产所导致的总产科护理成本影响较小。该研究还发现，医生的防御性反应因母亲的社会经济地位而异。