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评论:政策视角下的医疗事故改革

Commentary: malpractice reform in policy perspective.

作者信息

Bovbjerg Randall R

机构信息

The Urban Institute, Washington, DC 20037, USA.

出版信息

Milbank Q. 2007 Jun;85(2):297-305. doi: 10.1111/j.1468-0009.2007.00488.x.

Abstract

Enacted caps on malpractice awards and proposed early offer reform address the sometimes excessive verdicts of conventional liability and its very high overhead costs. However, such reforms greatly benefit medical defendants while doing too little for claimants or patients in general. Caps and early offer only affect current claims; far broader reforms are therefore needed to improve the woeful performance of liability as a general promoter of patient safety and injury compensation. Broad reforms, however desirable, seldom surmount high political and practical hurdles. A good, more evenhanded start would seek to make claims resolution faster, more accurate, more predictable, and less expensive, while separately promoting medical quality and safety as well as greater transparency for law, medicine, and insurance.

摘要

对医疗事故赔偿设定上限以及提议的提前报价改革,解决了传统责任制度中有时过高的裁决以及其极高的间接成本问题。然而,此类改革极大地有利于医疗被告,而总体上对索赔人或患者的帮助却微乎其微。赔偿上限和提前报价仅影响当前的索赔;因此,需要进行更广泛的改革,以改善责任制度在促进患者安全和伤害赔偿方面糟糕的表现。广泛的改革,无论多么可取,很少能跨越高度的政治和实际障碍。一个良好、更公平的开端将力求使索赔解决更快、更准确、更可预测且成本更低,同时分别促进医疗质量和安全以及法律、医学和保险领域更高的透明度。

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