Taragin M I, Wilczek A P, Karns M E, Trout R, Carson J L
Division of General Internal Medicine, University of Medicine and Dentistry of New Jersey (UMDNJ), Robert Wood Johnson Medical School, New Brunswick 08903-0019.
Am J Med. 1992 Nov;93(5):537-42. doi: 10.1016/0002-9343(92)90582-v.
This study was undertaken to clarify which, if any, physician demographic characteristics are associated with an increased rate of medical malpractice claims.
We analyzed the malpractice experience of 9,250 physicians insured for at least 2 years from 1977 to 1987 in the state of New Jersey. After adjusting for years at risk, physician claims per year was categorized into low, medium, and high.
Male physicians were three times as likely to be in the high-claims group as female physicians, even after adjusting for other demographic variables (relative risk, 3.1; 99% confidence interval, 2.2 to 4.4). Specialty was strongly associated with claims rate, with neurosurgery, orthopedics, and obstetrics/gynecology having 7 to 12 times the number of claims per year as psychiatry, the specialty with the fewest claims. The rate of claims varied with age (p < 0.001) and peaked at approximately age 40. No association was evident between claims rate and a physician's site of training or type of degree.
Male physicians are three times as likely to be in a high-claims category as female physicians. We suspect that the most likely explanation for this finding is that women interact more effectively with patients. Understanding the reasons for the variation in claim rates between physicians may lead to the development of methods to reduce the overall rate of malpractice claims.
本研究旨在明确哪些医生人口统计学特征(若存在的话)与医疗事故索赔率增加相关。
我们分析了1977年至1987年期间在新泽西州投保至少两年的9250名医生的医疗事故经历。在对风险年限进行调整后,将每年的医生索赔情况分为低、中、高三类。
即使在对其他人口统计学变量进行调整后,男性医生进入高索赔组的可能性仍是女性医生的三倍(相对风险为3.1;99%置信区间为2.2至4.4)。专业与索赔率密切相关,神经外科、骨科以及妇产科每年的索赔数量是索赔最少的精神科的7至12倍。索赔率随年龄变化(p < 0.001),在大约40岁时达到峰值。索赔率与医生的培训地点或学位类型之间没有明显关联。
男性医生进入高索赔类别的可能性是女性医生的三倍。我们怀疑这一发现最可能的解释是女性与患者的互动更有效。了解医生之间索赔率差异的原因可能会促使开发出降低医疗事故索赔总体率的方法。