Tsimtsiou Z, Kirana Ps, Hatzimouratidis K, Hatzichristou D
Institute for Urological Diseases, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Institute for Urological Diseases, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 2nd Department of Urology of "Papageorgiou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Hippokratia. 2014 Apr;18(2):139-43.
Patients vary considerably in their intentions to pursue legal action following a medical error. The aim of this study was to explore predictors of litigious intentions in both hospitalized patients and outpatients, determining the relative influences of patients' characteristics, help-seeking behavior, information-seeking attitudes and general health status factors.
A representative cross-section of the urologic clinic of a general academic hospital and the associated outpatient clinic was used (a total of 226 patients, 145 outpatients). Data were gathered using in-person interviews conducted by trained psychologists. Attitudes were assessed by "General statements about medical errors", while expectations for information by "Krantz's Health Opinion Survey" (KHOS).
A single multivariate model explained 21.5% of the variance of litigious intentions. Younger age (explained 7.6% of the variation, p=0.04), weaker relationship with religion (4%, p=0.02), less than 15 visits/year to any physician (7.2%, p=0.001), outpatient status (2.4%, p=0.02), and higher expectations for information were associated with higher possibility to consider suing their physician (7.6%, p=0.002). Patients' desire for disclosure of a medical error (agreement in 82.2%) exceeded their expectations for financial compensation, particularly in less severe cases (agreement in 24.1%).
This is the first report on the profile of patients with high potential for malpractice suits as predicted by patients' age, relationship with religion, health-seeking and information-seeking behavior. Respecting patients' need for information during clinical consultations and proceeding to disclosure of medical errors, when they occur, seems to be not only the more patient-centered approach, but also the best way to lessen the likelihood of a claim. Hippokratia 2014; 18 (2):139-143.
患者在医疗差错后采取法律行动的意愿差异很大。本研究的目的是探讨住院患者和门诊患者诉讼意愿的预测因素,确定患者特征、求助行为、信息寻求态度和一般健康状况因素的相对影响。
使用一家综合学术医院泌尿外科诊所及其相关门诊的代表性横断面样本(共226例患者,其中145例门诊患者)。数据通过由训练有素的心理学家进行的面对面访谈收集。态度通过“关于医疗差错的一般陈述”进行评估,而对信息的期望通过“克兰茨健康意见调查”(KHOS)进行评估。
一个单一的多变量模型解释了诉讼意愿方差的21.5%。年龄较小(解释了7.6%的变异,p = 0.04)、与宗教的关系较弱(4%,p = 0.02)、每年看医生次数少于15次(7.2%,p = 0.001)、门诊患者身份(2.4%,p = 0.02)以及对信息的期望较高与考虑起诉医生的可能性较高相关(7.6%,p = 0.002)。患者对医疗差错披露的渴望(82.2%表示同意)超过了他们对经济赔偿的期望,尤其是在不太严重的情况下(24.1%表示同意)。
这是第一份关于根据患者年龄、与宗教的关系、寻求健康和寻求信息行为预测的具有高医疗事故诉讼可能性患者特征的报告。在临床咨询期间尊重患者对信息的需求,并在医疗差错发生时进行披露,似乎不仅是以患者为中心的更好方法,也是降低索赔可能性的最佳途径。《希波克拉底》2014年;18(2):139 - 143。