Sloan F A, Mergenhagen P M, Burfield W B, Bovbjerg R R, Hassan M
Health Policy Center, Vanderbilt University, Nashville, TN 37235.
JAMA. 1989 Dec 15;262(23):3291-7.
This study uses a large malpractice database from Florida to assess the concentration of losses among physicians, predictability of claims experience, characteristics of physicians with favorable vs unfavorable experience, and effects of claims experience on physicians' practice decisions and on actions taken by the state's licensing board. Most payments by insurers involved a comparatively small number of physicians. Physicians with relatively prestigious credentials had no better, and on some indicators, worse claims experience. If anything, physicians with adverse claims experience were less likely to make subsequent changes in their practice, such as quitting practice or moving to another state. Physicians with very poor claims histories were more likely to have complaints filed against them with the Florida licensing board, but the sanctions against physicians with either poor or excellent histories were not severe. Physicians with adverse claims experience from incidents that arose between 1975 and 1980 had appreciably worse claims experience from incidents that arose during 1981 to 1983.
本研究使用来自佛罗里达州的一个大型医疗事故数据库，以评估医生群体中损失的集中程度、索赔经历的可预测性、具有有利或不利经历的医生的特征，以及索赔经历对医生执业决策和该州执照颁发委员会所采取行动的影响。保险公司的大多数赔付涉及相对少数的医生。拥有相对有声望资质的医生并没有更好的索赔经历，而且在某些指标上，索赔经历更糟。如果有什么不同的话，有不良索赔经历的医生在随后改变其执业方式（如停止执业或搬到另一个州）的可能性较小。索赔历史极差的医生更有可能被佛罗里达州执照颁发委员会投诉，但对索赔历史不佳或良好的医生的制裁并不严厉。在1975年至1980年期间发生的事件中有不良索赔经历的医生，在1981年至1983年期间发生的事件中的索赔经历明显更糟。
