Hernandez Lyndon V, Klyve Dominic, Regenbogen Scott E
Lyndon V Hernandez, Department of Gastroenterology, Aurora Medical Center and GI Associates, LLC, Kenosha, WI 53142, United States.
World J Gastrointest Endosc. 2013 Apr 16;5(4):169-73. doi: 10.4253/wjge.v5.i4.169.
To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure.
We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time.
There were 1901 endoscopy-related closed claims against all providers from 1985 to 2008. The specialties include: internal medicine (n = 766), gastroenterology (n = 562), general surgery (n = 231), general and family practice (n = 101), colorectal surgery (n = 87), other specialties (n = 132), and unknown (n = 22). Colonoscopy represented the highest frequencies of closed claims (n = 788) and the highest total indemnities ($54 093 000). In terms of mean claims payment, endoscopic retrograde cholangiopancreatography (ERCP) ranked the highest ($374 794) per claim. Internists had the highest number of total claims (n = 766) and total claim payment ($70 730 101). Only total claim payments for colonoscopy and ERCP seem to have increased over time. Indeed, there was an average increase of 15.5% per year for colonoscopy and 21.9% per year for ERCP after adjusting for inflation.
There appear to be differences in malpractice coverage costs among specialties and the type of endoscopic procedure. There is also evidence for secular trend in total claim payments, with colonoscopy and ERCP costs rising yearly even after adjusting for inflation.
总结内镜检查相关索赔的规模和时间趋势，并根据专业和操作比较医疗事故赔偿总额。
我们从一家专业责任保险承保商行业协会的综合结案索赔数据库中获取数据，该数据库代表了超过60%的美国执业医师。计算按操作和年份的总赔付额，并根据通货膨胀（使用消费者价格指数）调整为2008年美元。进行时间序列分析以评估每种操作类型的索赔总价值随时间的变化。
1985年至2008年期间，针对所有医疗服务提供者有1901例与内镜检查相关的结案索赔。专业包括：内科（n = 766）、胃肠病学（n = 562）、普通外科（n = 231）、普通和家庭医学（n = 101）、结直肠外科（n = 87）、其他专业（n = 132）以及未知（n = 22）。结肠镜检查的结案索赔频率最高（n = 788），总赔偿额最高（54093000美元）。就平均索赔赔付而言，内镜逆行胰胆管造影术（ERCP）每项索赔排名最高（374794美元）。内科医生的索赔总数（n = 766）和索赔总赔付额（70730101美元）最高。似乎只有结肠镜检查和ERCP的索赔总赔付额随时间有所增加。实际上，在调整通货膨胀后，结肠镜检查每年平均增长15.5%，ERCP每年平均增长21.9%。
不同专业和内镜操作类型的医疗事故保险成本似乎存在差异。也有证据表明索赔总赔付额存在长期趋势，即使在调整通货膨胀后，结肠镜检查和ERCP的成本仍逐年上升。
