Bassett Heart Care Institute, Cooperstown, NY.
Department of Emergency Medicine, Keck School of Medicine and Leonard D. Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, CA.
Am Heart J. 2014 May;167(5):690-6. doi: 10.1016/j.ahj.2014.02.007. Epub 2014 Feb 26.
Medical professional liability (MPL) remains a significant burden for physicians, in general, and cardiologists, in particular, as recent research has shown that average MPL defense costs are higher in cardiology than other specialties. Knowledge of the clinical characteristics and outcomes of lawsuits against cardiologists may improve quality of care and risk management.
We analyzed closed MPL claims of 40,916 physicians and 781 cardiologists insured by a large nationwide insurer for ≥1 policy year between 1991 and 2005.
The annual percentage of cardiologists facing an MPL claim was 8.6%, compared with 7.4% among physicians overall (P < .01). Among 530 claims, 72 (13.6%) resulted in an indemnity payment, with a median size of $164,988. Mean defense costs for claims resulting in payment were $83,593 (standard deviation (s.d.) $72,901). The time required to close MPL claims was longer for claims with indemnity payment than claims without (29.6 versus 18.9 months; P < .001). More than half of all claims involved a patient's death (304; 57.4%), were based on inpatient care (379; 71.5%), or involved a primary cardiovascular condition (416; 78.4%). Acute coronary syndrome was the most frequent condition (234; 44.2%). Medical professional liability claims involving noncardiovascular conditions were common (66; 12.5%) and included falls or mechanical injuries had while under a cardiologist's care and a failure to diagnose cancer.
Rates of malpractice lawsuits are higher among cardiologists than physicians overall. A substantial portion of claims are noncardiovascular in nature.
医学专业责任（MPL）仍然是医生的一个重大负担，尤其是心脏病专家，因为最近的研究表明，心脏病学的平均 MPL 辩护成本高于其他专业。了解针对心脏病专家的诉讼的临床特征和结果可能会提高护理质量和风险管理水平。
我们分析了一家大型全国性保险公司承保的 40916 名医生和 781 名心脏病专家的封闭 MPL 索赔，这些医生和心脏病专家在 1991 年至 2005 年期间至少有 1 份保单。
每年面临 MPL 索赔的心脏病专家比例为 8.6%，而总体医生为 7.4%（P<.01）。在 530 项索赔中，有 72 项（13.6%）导致赔偿金支付，中位数为 164988 美元。导致付款的索赔的辩护费用平均值为 83593 美元（标准差（s.d.）为 72901 美元）。有赔偿金支付的 MPL 索赔的结案时间长于没有赔偿金支付的索赔（29.6 个月与 18.9 个月；P<.001）。超过一半的索赔涉及患者死亡（304 项；57.4%），基于住院治疗（379 项；71.5%）或涉及主要心血管疾病（416 项；78.4%）。急性冠状动脉综合征是最常见的病症（234 项；44.2%）。涉及非心血管疾病的 MPL 索赔很常见（66 项；12.5%），包括在心脏病专家护理下跌倒或机械性损伤以及未能诊断癌症。
心脏病专家的医疗事故诉讼率高于总体医生。索赔的很大一部分性质是非心血管的。
