School of Health and Related Research, University of Sheffield, Sheffield, England, UK.
School of Health and Related Research, University of Sheffield, Sheffield, England, UK.
Value Health. 2022 Aug;25(8):1404-1415. doi: 10.1016/j.jval.2022.01.020. Epub 2022 Apr 5.
This article determines public stated preferences around different factors that influence the choice to make clinical negligence claims against a national healthcare system.
A large online survey was conducted using a discrete choice experiment (DCE) with the UK general population (N = 1013). DCE tasks involved a single profile and participants chose whether to make a claim for compensation (yes/no) after one of 3 randomly allocated patient safety incident (PSI) "scenarios" of different severities (mild, moderate, severe). DCE attributes described the actions of the healthcare system after a PSI and characteristics of the clinical negligence claims process. The data were modeled separately for each scenario (mild, moderate, severe) using logistic regression. Marginal effects and the probability of making a claim in a baseline case were estimated.
Probability of choosing to claim was reduced by receipt of an apology, investigation and prevention of recurrence of the PSI, and longer time until claim decision and increased by an easy and straightforward claims process and high chance of compensation and for the mild scenario higher compensation amounts. Marginal effects and baseline case probabilities differed by scenario severity.
The results suggest the actions of the healthcare system after a PSI and characteristics of the claims process have a larger impact on the probability of making a claim for milder PSIs. For more severe PSIs, a larger probability of making a claim was observed, and the choice was less influenced by the actions of the healthcare system after the PSI and characteristics of the claims process.
本文旨在确定公众对影响向国家医疗保健系统提出临床疏忽索赔的不同因素的偏好。
使用具有英国普通人群（N=1013）的离散选择实验（DCE）进行了一项大型在线调查。DCE 任务涉及单一档案，参与者在 3 种不同严重程度（轻度、中度、重度）的患者安全事件（PSI）“场景”之一后选择是否提出赔偿索赔（是/否）。DCE 属性描述了 PSI 后医疗保健系统的行动以及临床疏忽索赔过程的特征。使用逻辑回归分别为每个场景（轻度、中度、重度）对数据进行建模。估计了边际效应和基准案例中的索赔概率。
接受道歉、调查和防止 PSI 再次发生、直到索赔决定的时间延长以及简化和直接的索赔流程以及高赔偿机会降低了选择索赔的可能性，而对于轻度情况，较高的赔偿金额则增加了选择索赔的可能性。边际效应和基准案例的概率因场景严重程度而异。
结果表明，PSI 后医疗保健系统的行动和索赔过程的特征对轻度 PSI 提出索赔的可能性影响更大。对于更严重的 PSI，提出索赔的可能性更大，并且选择受 PSI 后医疗保健系统的行动和索赔过程的特征影响较小。
