Kachalia Allen, Shojania Kaveh G, Hofer Timothy P, Piotrowski Marcia, Saint Sanjay
Brigham and Women's/Faulkner Hospitalist Program, Department of Medicine, Brigham and Women's Hospital, Boston, USA.
Jt Comm J Qual Saf. 2003 Oct;29(10):503-11. doi: 10.1016/s1549-3741(03)29060-2.
Mandatory disclosure of medical errors has been advocated to improve patient safety. Many resist mandatory disclosure policies because of concerns about increasing malpractice exposure. It has been countered that malpractice liability actually decreases when there is full disclosure of medical errors. A comprehensive literature search was conducted to determine what is known about the impact of full disclosure on malpractice liability.
Electronic searches of multiple databases were supplemented with hand searches of bibliographies and communication with recognized experts in the field.
Screening the titles, abstracts, and, in many cases, the full articles from more than an estimated 5,200 citations resulted in identification of one published study directly examining malpractice liability when a policy of full disclosure was implemented.
Despite extensive literature on the impact of disclosure on malpractice liability, few well-designed studies have focused on the real-world impact on the volume and cost of suits following implementation of a full disclosure policy. Many articles examine why patients sue their doctors, suggesting that some lawsuits may be averted by disclosure, but the articles do not allow us to estimate the additional suits that would be created by disclosure. Additional studies addressing the effect of disclosure on malpractice liability are needed.
为提高患者安全，人们主张强制披露医疗差错。许多人因担心增加医疗事故风险而抵制强制披露政策。有人反驳称，全面披露医疗差错时，医疗事故责任实际上会降低。为确定全面披露对医疗事故责任的影响，我们进行了全面的文献检索。
在多个数据库进行电子检索，并辅以对参考文献的手工检索以及与该领域知名专家的交流。
从估计超过5200条引用文献中筛选标题、摘要，在许多情况下还筛选全文，最终确定了一项已发表的研究，该研究直接考察了实施全面披露政策时的医疗事故责任。
尽管有大量关于披露对医疗事故责任影响的文献，但很少有精心设计的研究关注全面披露政策实施后对诉讼数量和成本的实际影响。许多文章探讨了患者起诉医生的原因，表明披露可能避免一些诉讼，但这些文章无法让我们估计披露会引发的额外诉讼。需要更多研究来探讨披露对医疗事故责任的影响。
