Hagihara Akihito, Tarumi Kimio
Department of Health Services Management & Policy, Kyushu University Graduate School of Medicine, Fukuoka 812-8582, Japan.
Health Policy. 2007 Oct;83(2-3):213-22. doi: 10.1016/j.healthpol.2007.01.005. Epub 2007 Feb 20.
Although findings of an association between physician communicative behaviors and the quality of health care have accumulated, the relationship between physician explanatory behaviors and negligent care has not been examined. The purpose of the study is to explore the association between physicians' explanatory behaviors and judges' decisions in lawsuits on negligent care.
We analyzed the decisions made by 10 of the 47 district courts in Japan between 1986 and 1998. We employed two types of linear model to examine the association between physician explanatory behaviors and findings of medical negligence.
The quality of a physician's explanatory behaviors, together with listening and talking to the patient or family, was related to decreased probability of a court decision of negligent care. However, explaining and listening to patients or their families were also related to the increased level of compensation.
The results imply that physician's explanatory behaviors accompanied by explaining and listening to patients or their families markedly reduces the risk of a negligent care decision. However, more detailed communication of the facts about a case was associated with an increased level of compensation in the context of cases filed for medical negligence.
尽管关于医生沟通行为与医疗质量之间关联的研究结果不断累积,但医生解释行为与医疗过失之间的关系尚未得到研究。本研究旨在探讨医生解释行为与医疗过失诉讼中法官裁决之间的关联。
我们分析了日本47个地方法院中的10个在1986年至1998年间做出的裁决。我们采用了两种线性模型来检验医生解释行为与医疗过失认定之间的关联。
医生解释行为的质量,以及与患者或家属的倾听和交谈,与法院判定医疗过失的可能性降低有关。然而,向患者或其家属解释和倾听也与赔偿水平的提高有关。
结果表明,医生在向患者或其家属解释和倾听的同时所做出的解释行为,显著降低了判定医疗过失的风险。然而,在医疗过失诉讼案件中,更详细地说明案件事实与赔偿水平的提高有关。