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美国儿科医生的医疗事故风险。

Malpractice risk among US pediatricians.

机构信息

Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.

出版信息

Pediatrics. 2013 Jun;131(6):1148-54. doi: 10.1542/peds.2012-3443. Epub 2013 May 6.

Abstract

OBJECTIVE

To characterize malpractice risk among US pediatricians.

METHODS

We analyzed malpractice claims of all pediatricians and other physicians covered by a nationwide liability insurer from 1991 to 2005 (n = 1630 pediatricians; 40 916 total physicians). We characterized annual malpractice risk among pediatricians compared with other physicians. We characterized claims according to patient age, injury type, months required to resolve the claim, and whether an indemnity payment was made. We estimated how patient age and injury type were associated with whether a claim resulted in payment to a patient (and if so, payment size) and the time required to resolve the claim.

RESULTS

The annual percentage of pediatricians facing a malpractice claim was 3.1% (7.4% among other physicians, P < .001). Among 404 claims, 83 (20.5%) resulted in an indemnity payment and 15 (3.7%) resulted in a payment exceeding $1 million. Annual rates of indemnity were lower among pediatricians (0.5%) than other physicians (1.6%, P < .001), whereas rates of payments exceeding $1 million were similar (0.13% among pediatricians and 0.11% among other physicians, P = .57). The mean indemnity payment was $562 180 (SD $667 962). Cases with permanent injury (n = 172) had larger mean payments ($703 373) compared with fatalities ($559 102; n = 131) or temporary or psychological injuries ($127 663; n = 101), P < .05. The mean time to resolution was 23.4 months (SD 21.8 months).

CONCLUSIONS

Indemnity payments among pediatricians are infrequent but large, particularly in cases with permanent patient injury rather than death or temporary injury. The time required to resolve claims may be considered to be long.

摘要

目的

描述美国儿科医生的医疗事故风险特征。

方法

我们分析了一家全国性责任保险公司在 1991 年至 2005 年期间承保的所有儿科医生和其他医生的医疗事故索赔(n=1630 名儿科医生;40916 名医生总数)。我们描述了儿科医生与其他医生相比的年度医疗事故风险。我们根据患者年龄、伤害类型、解决索赔所需的月数以及是否进行赔偿付款来描述索赔。我们估计了患者年龄和伤害类型与索赔是否导致向患者付款(如果是,付款金额)以及解决索赔所需的时间之间的关系。

结果

儿科医生面临医疗事故索赔的年百分比为 3.1%(其他医生为 7.4%,P<.001)。在 404 起索赔中,83 起(20.5%)导致赔偿付款,15 起(3.7%)导致付款超过 100 万美元。儿科医生的赔偿率(0.5%)低于其他医生(1.6%,P<.001),而付款超过 100 万美元的比例相似(儿科医生为 0.13%,其他医生为 0.11%,P=0.57)。平均赔偿付款为 562180 美元(SD 667962 美元)。永久性损伤的病例(n=172)的平均赔偿金额(703373 美元)高于死亡病例(n=131)或暂时或心理损伤病例(n=101)(559102 美元和 127663 美元),P<.05。解决索赔的平均时间为 23.4 个月(SD 21.8 个月)。

结论

儿科医生的赔偿付款虽不常见但金额较大,尤其是在永久性患者损伤而非死亡或暂时损伤的情况下。解决索赔所需的时间可能被认为很长。

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本文引用的文献

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Outcomes of medical malpractice litigation against US physicians.针对美国医生的医疗事故诉讼结果。
Arch Intern Med. 2012 Jun 11;172(11):892-4. doi: 10.1001/archinternmed.2012.1416.
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Defense costs of medical malpractice claims.医疗事故索赔的辩护费用。
N Engl J Med. 2012 Apr 5;366(14):1354-6. doi: 10.1056/NEJMc1114805.
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Malpractice risk according to physician specialty.根据医师专业划分的医疗事故风险。
N Engl J Med. 2011 Aug 18;365(7):629-36. doi: 10.1056/NEJMsa1012370.
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Pediatrics. 2008 Dec;122(6):e1282-6. doi: 10.1542/peds.2008-1594.
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The impact of malpractice fears on cesarean section rates.对医疗事故的担忧对剖宫产率的影响。
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