National Centre for Emergency Primary Health Care, NORCE Norwegian Research Centre, Bergen, Norway.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Scand J Prim Health Care. 2021 Dec;39(4):429-437. doi: 10.1080/02813432.2021.1973240. Epub 2021 Oct 7.
The aim of this study was to examine the associations between characteristics of physicians working in primary care emergency units (PCEUs) and the outcome of assessments of the medical records.
Data from a previous case-control study was used to evaluate factors related to medical errors.
Ten Norwegian PCEUs were included.
Physicians that had evoked a patient complaint, and a random sample of three physicians from the same PCEU and time period as the physician who had evoked a complaint. Recorded physician characteristics were: gender, seniority, citizenship at, and years after authorization as a physician, specialty in general practice, and workload at the PCEU. Main outcome measures: Assessments of the medical records: errors that may have led to harm, no medical error, or inconclusive.
In the complaint group 77 physicians were included, and in the random sample group 217. In the first group, 53.2% of the medical records were assessed as revealing medical errors. In the random sample group, this percentage was 3.2. In the complaint group the percentages for no-error and inconclusive for the female physicians were 30.8 and 15.4; and for the male physicians 9.8 and 27.3, = 0.027.
In the group of complaints there was a higher percentage with no assessed medical error, and a lower percentage with inconclusive assessments of medical errors, among female physicians compared to their male colleagues. We found no other physician factors that were associated with assessed medical errors. Future research should focus on the underlying elements of these findings.Key pointsMedical errors are among the leading causes of death and they are essentially avoidable. Primary care emergency units are a vulnerable arena for committing medical errors.By assessing the medical records of a group of physicians who had evoked a complaint, no differences related to physician factors were revealed in the incidence of medical errors.In the group of female physicians, the proportion of no-errors, was higher, and the percentage of inconclusive medical records was lower than for their male colleagues.The Norwegian regulations on independent participation in PCEUs may have modulated these results.
本研究旨在探讨在初级保健急诊单位(PCEU)工作的医生的特征与病历评估结果之间的关联。
使用先前病例对照研究的数据评估与医疗差错相关的因素。
纳入了挪威的 10 个 PCEU。
引发患者投诉的医生,以及同一 PCEU 和同一时期与引发投诉的医生的随机抽取的三位医生。记录的医生特征包括:性别、资历、公民身份和授权为医生后的年限、全科医学专业和在 PCEU 的工作量。主要观察指标:病历评估:可能导致伤害的错误、无医疗差错或不确定。
在投诉组中纳入了 77 名医生,在随机样本组中纳入了 217 名医生。在第一组中,53.2%的病历被评估为存在医疗差错。在随机样本组中,这一比例为 3.2%。在投诉组中,女性医生的无错误和不确定评估百分比分别为 30.8%和 15.4%;而男性医生的百分比分别为 9.8%和 27.3%,=0.027。
在投诉组中,与男性同事相比,女性医生的无评估医疗差错比例更高,不确定评估医疗差错的比例更低。我们没有发现其他与评估医疗差错相关的医生因素。未来的研究应集中于这些发现的潜在因素。
医疗差错是导致死亡的主要原因之一,而且这些差错基本上是可以避免的。
初级保健急诊单位是发生医疗差错的脆弱领域。
通过评估一组引发投诉的医生的病历,没有发现与医生因素相关的医疗差错发生率差异。
在女性医生组中,无差错的比例较高,不确定的病历比例较低,而男性同事的比例则相反。
挪威关于独立参与 PCEU 的规定可能调节了这些结果。