Department of Radiology, University of Washington, Seattle, Washington; Cleareview, Inc, Seattle, Washington.
Department of Radiology, University of Washington, Seattle, Washington.
J Am Coll Radiol. 2020 Jan;17(1 Pt A):42-45. doi: 10.1016/j.jacr.2019.08.003. Epub 2019 Aug 27.
While several studies analyze radiology malpractice lawsuits, none specifically examines the site of service. The purpose of this study is to estimate the relative likelihood of a lawsuit arising from a radiology study performed in emergency (ED), inpatient (IP) and outpatient (OP) settings.
Referrals from a malpractice review consulting company over a six year period were compared to the 2016 Medicare Part B file and stratified by site of service. The proportion of exams for each site of service was estimated, and using absolute differences in proportions and odds ratios (ORs), differences in the place of service were calculated.
The Cleareview cohort contained 25 (17%) IP, 56 (38%) OP, and 68 (46%) ED exams. In 2016, Medicare assigned benefits for 27,009,053 (20%) IP, 84,075,848 (62%) OP and 23,964,794 (18%) ED exams. The ORs (Cleareview: Medicare) of the ED to IP, OP, and IP+OP were 3.07 (95% CI: 1.56-6.03), 4.26 (95% CI: 2.76-6.59), 3.89 (95% CI: 2.60-5.83), respectively. By contrast, the OR for IP:OP between Cleareview and Medicare was not significantly different than 1 (OR: 1.39, 95% CI: 0.68-2.83, P = .38).
Radiological studies performed in the ED accounted for a disproportionate number of liability claims against radiologists. Further study is warranted to confirm this finding with a more robust data set.
虽然有几项研究分析了放射科医疗事故诉讼，但没有一项专门研究服务地点。本研究的目的是评估在急诊（ED）、住院（IP）和门诊（OP）环境中进行放射学检查时出现诉讼的相对可能性。
在六年期间，从医疗事故审查咨询公司收到的转介与 2016 年医疗保险 B 部分档案进行了比较，并按服务地点进行了分层。估计了每个服务地点的检查比例，并使用比例的绝对差异和比值比（OR），计算了服务地点的差异。
Cleareview 队列包含 25 例（17%）IP、56 例（38%）OP 和 68 例（46%）ED 检查。在 2016 年，医疗保险为 27,009,053 例（20%）IP、84,075,848 例（62%）OP 和 23,964,794 例（18%）ED 检查分配了福利。ED 与 IP、OP 和 IP+OP 的 OR（Cleareview：医疗保险）分别为 3.07（95%CI：1.56-6.03）、4.26（95%CI：2.76-6.59）和 3.89（95%CI：2.60-5.83）。相比之下，Cleareview 和医疗保险之间的 IP：OP 的 OR 没有显著不同于 1（OR：1.39，95%CI：0.68-2.83，P=0.38）。
在 ED 进行的放射学研究导致针对放射科医生的责任索赔数量不成比例。需要进一步的研究来用更强大的数据集证实这一发现。
