开发州级医疗事故环境综合衡量指标。
Development of a composite measure of state-level malpractice environment.
机构信息
Division of Surgical Oncology and the Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
出版信息
Health Serv Res. 2014 Apr;49(2):751-66. doi: 10.1111/1475-6773.12110. Epub 2013 Oct 11.
OBJECTIVE
To develop a composite measure of state-level malpractice environment.
DATA SOURCES
Public use data from the National Practitioner Data Bank, Medical Liability Monitor, the National Conference of State Legislatures, and the American Bar Association.
STUDY DESIGN
Principal component analysis of state-level indicators (paid claims rate, malpractice premiums, lawyers per capita, average award size, and malpractice laws), with indirect validation of the composite using receiver-operating characteristic curves to determine how accurately the composite could identify states with high-tort activity and costs.
PRINCIPAL FINDINGS
A single composite accounted for over 73 percent of total variance in the seven indicators and demonstrated reasonable criterion validity.
CONCLUSION
An empirical composite measure of state-level malpractice risk may offer advantages over single indicators in measuring overall risk and may facilitate cross-state comparisons of malpractice environments.
目的
开发一种州级医疗事故环境的综合衡量指标。
资料来源
国家执业医师数据库、医疗责任监测、全国州立法会议和美国律师协会的公共使用数据。
研究设计
对州级指标（已支付索赔率、医疗事故保险费、人均律师数、平均赔偿额和医疗事故法）进行主成分分析，并使用受试者工作特征曲线对综合指标进行间接验证，以确定综合指标在识别高侵权活动和成本的州方面的准确性。
主要发现
单一综合指标解释了七个指标中超过 73%的总方差，并且具有合理的判别效度。
结论
州级医疗事故风险的实证综合衡量指标在衡量总体风险方面可能优于单一指标，并有助于对医疗事故环境进行跨州比较。
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