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医学法律问题:意大利神经外科学界的认知、意识和行为变化:基于调查的分析。

Medicolegal Issues: Perception, Awareness, and Behavioral Changes Among Italian Neurosurgical Community: Survey-Based Analysis.

机构信息

Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Department of Neurosurgery, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy.

Institute of Neurosurgery, A. Gemelli University Polyclinic, IRCCS and Foundation, Sacred Heart Catholic University, Rome.

出版信息

World Neurosurg. 2021 Oct;154:e774-e780. doi: 10.1016/j.wneu.2021.07.145. Epub 2021 Aug 6.

Abstract

BACKGROUND

Despite the rising trend of medicolegal challenges in Italy, there is a significant lack of literature on this topic. To provide better understanding of awareness toward medicolegal aspects, defensive behavior, consent-taking practice, and general perceptions of Italian neurosurgeons on this issue, a cross-sectional survey was conducted.

METHODS

A questionnaire covering various aspects of medicolegal issues, in an anonymous online form, was sent to neurosurgeons practicing in Italy via e-mail-through a national mailing list-and social media platforms. The data collection period was November 1, 2020 to December 31, 2020.

RESULTS

A total of 64 single responses were included. We assessed 1) awareness of Italian neurosurgeons about a legal framework: a low level of knowledge has been reported-87.5% were unaware of the terms and conditions outlined by the contract with the institution, 75.6% of respondents stated they didn't know the main body of law that governed the medical community; and 2) perception toward defensive medicine: 92.2% believed that they were not trained to face possible medicolegal issues, but only a few tried to acquire more knowledge about medical legal issues, such as learning how to obtain a proper informed consent for a surgical procedure (34.4%).

CONCLUSIONS

This study marks the first survey to identify the perceptions among Italian neurosurgeons of medical legal issues and related "defensive medicine" practices: This is of relevance given its exorbitant cost in terms of public expenditure, psychologic burden, and its relevant impact on health care delivery.

摘要

背景

尽管意大利医学法律挑战呈上升趋势,但关于这一主题的文献却很少。为了更好地了解意大利神经外科医生对医学法律方面的认识、防御行为、同意书获取实践以及对这一问题的总体看法,我们进行了一项横断面调查。

方法

通过国家邮件列表和社交媒体平台,以匿名在线表格的形式向意大利的神经外科医生发送了一份涵盖医学法律问题各个方面的问卷。数据收集期为 2020 年 11 月 1 日至 12 月 31 日。

结果

共纳入 64 份单项回复。我们评估了 1)意大利神经外科医生对法律框架的认识:报告称他们的知识水平较低——87.5%的人不知道与机构签订的合同中规定的条款和条件,75.6%的受访者表示他们不知道管理医疗界的主要法律主体;以及 2)对防御性医疗的看法:92.2%的人认为他们没有接受过如何应对可能出现的医学法律问题的培训,但只有少数人试图获取更多关于医学法律问题的知识,例如学习如何为手术获得适当的知情同意(34.4%)。

结论

这项研究首次调查了意大利神经外科医生对医学法律问题及其相关“防御性医疗”实践的看法:鉴于其在公共支出、心理负担方面的高昂代价,以及对医疗服务提供的相关影响,这一点具有重要意义。

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