From the Department of Public Health, Section of Legal Medicine, Catholic University "Sacro Cuore" of Rome, Rome, Italy.
Center for Applied Pediatric Quality Analytics, Boston Children's Hospital.
J Patient Saf. 2019 Dec;15(4):e78-e81. doi: 10.1097/PTS.0000000000000460.
Italy is experiencing a crisis of malpractice litigation with important repercussions on the insurance industry (e.g., lower profits), physicians (e.g., defensive medicine), and the courts (e.g., work backlog, lengthy proceedings). We searched for common ground between legal systems in Italy and the United States and considered the implications for international collaborations in patient safety.
We examined the judicial frameworks of medical malpractice litigation in two countries with different legal foundations: the United States (a public-private system governed by common law) and Italy (a publicly financed healthcare system governed by civil law).
We found important differences and similarities across the two systems that suggest a high compatibility for future comparisons and collaborations. Although many Italian hospitals maintain risk management programs, the U.S. emphasis on patient safety and quality has not yet been integrated into Italian healthcare systems.
Based on our findings, we propose that the Italian system might benefit from assertively adopting some concepts from the U.S. system. In particular, we consider the role of the law and Italian medicolegal experts as key facilitators for the integration of patient safety and risk management units within Italian healthcare facilities.
意大利正经历着医疗事故诉讼危机，这对保险业（例如，利润降低）、医生（例如，防御性医疗）和法院（例如，积压工作、冗长的诉讼程序）都产生了重要影响。我们在意大利和美国的法律体系之间寻找共同点，并考虑其对患者安全国际合作的影响。
我们研究了两个具有不同法律基础的国家（美国，一个由普通法管理的公私混合系统；意大利，一个由民法管理的公共资助医疗保健系统）的医疗事故诉讼司法框架。
我们发现两个系统之间存在重要的差异和相似之处，这表明未来的比较和合作具有很高的兼容性。尽管许多意大利医院都维持着风险管理项目，但美国对患者安全和质量的重视尚未融入意大利的医疗保健系统。
基于我们的发现，我们提出意大利系统可能受益于积极采用美国系统中的一些概念。特别是，我们认为法律和意大利法医专家的作用是促进意大利医疗机构内患者安全和风险管理部门整合的关键因素。
