Department of Medicine, Massachusetts General Hospital, and Harvard Medical School, Boston, USA.
N Engl J Med. 2011 Aug 18;365(7):629-36. doi: 10.1056/NEJMsa1012370.
Data are lacking on the proportion of physicians who face malpractice claims in a year, the size of those claims, and the cumulative career malpractice risk according to specialty.
We analyzed malpractice data from 1991 through 2005 for all physicians who were covered by a large professional liability insurer with a nationwide client base (40,916 physicians and 233,738 physician-years of coverage). For 25 specialties, we reported the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment (compensation paid to a plaintiff), and the size of indemnity payments. We estimated the cumulative risk of ever being sued among physicians in high- and low-risk specialties.
Each year during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic-cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties.
There is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties. The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs. (Funded by the RAND Institute for Civil Justice and the National Institute on Aging.).
缺乏关于医生在一年内面临医疗事故索赔的比例、这些索赔的规模以及根据专业划分的累积职业医疗事故风险的数据。
我们分析了一家大型专业责任保险公司在 1991 年至 2005 年期间为所有医生提供的医疗事故数据，该保险公司在全国范围内拥有客户基础（40916 名医生和 233738 名医生的承保年限）。对于 25 个专业，我们报告了一年内有医疗事故索赔的医生比例、导致赔偿支付（即向原告支付的赔偿金）的索赔比例以及赔偿支付的规模。我们估计了高风险和低风险专业医生中被起诉的累积风险。
在研究期间的每一年，都有 7.4%的医生有医疗事故索赔，其中 1.6%的索赔导致赔偿支付（即 78%的索赔没有向索赔人支付赔偿金）。每年面临索赔的医生比例从神经外科的 19.1%、心胸血管外科的 18.9%和普通外科的 15.3%到家庭医学的 5.2%、儿科的 3.1%和精神病学的 2.6%不等。平均赔偿支付额为 274887 美元，中位数为 111749 美元。皮肤科的平均赔偿支付额为 117832 美元，儿科的为 520923 美元。估计到 65 岁时，低风险专业的 75%的医生已经面临医疗事故索赔，而高风险专业的 99%的医生则面临这种情况。
各专业之间的医疗事故诉讼可能性和赔偿支付规模存在很大差异。在所有专业中，面临医疗事故索赔的累积风险都很高，尽管大多数索赔不会导致向原告支付赔偿金。（由 RAND 公民司法研究所和美国国家老龄化研究所资助）。
