Department of Emergency Medicine, Allegheny Health Network, Pittsburgh, PA; US Acute Care Solutions, Canton, OH.
Katz Graduate School of Business, University of Pittsburgh, Pittsburgh, PA.
Ann Emerg Med. 2018 Feb;71(2):157-164.e4. doi: 10.1016/j.annemergmed.2017.06.023. Epub 2017 Jul 26.
We examine the association between emergency physician characteristics and practice factors with the risk of being named in a malpractice claim.
We used malpractice claims along with provider, operational, and jurisdictional data from a national emergency medicine group (87 emergency departments [EDs] in 15 states from January 1, 2010, to June 30, 2014) to assess the relationship between individual physician and practice variables and being named in a malpractice claim. Individual and practice factors included years in practice, emergency medicine board certification, visit admission rate, relative value units generated per hour, total patients treated as attending physician of record, working at multiple facilities, working primarily overnight shifts, patient experience data percentile, and state malpractice environment. We assessed the relationship between emergency physician and practice variables and malpractice claims, using logistic regression.
Of 9,477,150 ED visits involving 1,029 emergency physicians, there were 98 malpractice claims against 90 physicians (9%). Increasing total number of years in practice (adjusted odds ratio 1.04; 95% confidence interval 1.02 to 1.06) and higher visit volume (adjusted odds ratio 1.09 per 1,000 visits; 95% confidence interval 1.05 to 1.12) were associated with being named in a malpractice claim. No other factors were associated with malpractice claims.
In this sample of emergency physicians, 1 in 11 were named in a malpractice claim during 4.5 years. Total number of years in practice and visit volume were the only identified factors associated with being named, suggesting that exposure to higher patient volumes and longer practice experience are the primary contributors to malpractice risk.
我们考察了急诊医师特征和实践因素与医疗事故索赔风险之间的关系。
我们使用医疗事故索赔以及来自全国急诊医学组的提供者、运营和司法数据（2010 年 1 月 1 日至 2014 年 6 月 30 日期间，来自 15 个州的 87 个急诊部）来评估个体医师和实践变量与医疗事故索赔之间的关系。个体和实践因素包括行医年限、急诊医学委员会认证、就诊入院率、每小时产生的相对价值单位、作为主治医生治疗的总患者人数、在多个医疗机构工作、主要上夜班、患者体验数据百分位数以及州医疗事故环境。我们使用逻辑回归评估了急诊医师和实践变量与医疗事故索赔之间的关系。
在涉及 1029 名急诊医师的 9477150 次 ED 就诊中，有 98 起医疗事故索赔针对 90 名医师（9%）。行医年限的增加（调整后的优势比 1.04；95%置信区间 1.02 至 1.06）和就诊量的增加（每增加 1000 次就诊调整后的优势比为 1.09；95%置信区间 1.05 至 1.12）与医疗事故索赔有关。没有其他因素与医疗事故索赔有关。
在这个样本的急诊医师中，每 11 名中有 1 名在 4.5 年内被提起医疗事故索赔。行医年限和就诊量是唯一与被点名相关的因素，这表明接触更高的患者量和更长的实践经验是医疗事故风险的主要因素。
