Law and Public Health Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
Law and Public Health Unit, Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia.
BMJ Open. 2022 Jun 1;12(6):e055432. doi: 10.1136/bmjopen-2021-055432.
To understand the association between medical negligence claims and doctors' sex, age, specialty, working hours, work location, personality, social supports, family circumstances, self-rated health, self-rated life satisfaction and presence of recent injury or illness.
Prospective cohort study of Australian doctors.
12 134 doctors who completed the Medicine in Australia: Balancing Employment and Life survey between 2013 and 2019.
Doctors named as a defendant in a medical negligence claim in the preceding 12 months.
649 (5.35%) doctors reported being named in a medical negligence claim during the study period. In addition to previously identified demographic factors (sex, age and specialty), we identified the following vocational and psychosocial risk factors for claims: working full time (OR=1.48, 95% CI 1.13 to 1.94) or overtime hours (OR 1.70, 95% CI 1.29 to 2.23), working in a regional centre (OR 1.69, 95% CI 1.37 to 2.08), increasing job demands (OR 1.16, 95% CI 1.04 to 1.30), low self-rated life satisfaction (OR 1.43, 95% CI 1.08 to 1.91) and recent serious personal injury or illness (OR 1.40, 95% CI 1.13 to 1.72). Having an agreeable personality was mildly protective (OR 0.91, 95% CI 0.83 to 1.00). When stratified according to sex, we found that working in a regional area, low self-rated life satisfaction and not achieving work-life balance predicted medical negligence claims in male, but not female, doctors. However, working more than part-time hours and having a recent personal injury or illness predicted medical negligence claims in female, but not male, doctors. Increasing age predicted claims more strongly in male doctors. Personality type predicted claims in both male and female doctors.
Modifiable risk factors contribute to an increased risk of medical negligence claims among doctors in Australia. Creating more supportive work environments and targeting interventions that improve doctors' health and well-being could reduce the risk of medical negligence claims and contribute to improved patient safety.
了解医疗过失索赔与医生性别、年龄、专业、工作时间、工作地点、个性、社会支持、家庭状况、自我健康评估、自我生活满意度以及近期受伤或患病之间的关联。
澳大利亚医生的前瞻性队列研究。
2013 年至 2019 年间完成《澳大利亚医学：平衡工作与生活》调查的 12134 名医生。
在过去 12 个月中被点名成为医疗过失索赔的被告的医生。
在研究期间，有 649 名（5.35%）医生报告了医疗过失索赔。除了先前确定的人口统计学因素（性别、年龄和专业）外，我们还确定了以下职业和心理社会风险因素与索赔相关：全职（OR=1.48，95%置信区间 1.13 至 1.94）或加班（OR 1.70，95%置信区间 1.29 至 2.23），在区域中心工作（OR 1.69，95%置信区间 1.37 至 2.08），工作要求增加（OR 1.16，95%置信区间 1.04 至 1.30），自我生活满意度低（OR 1.43，95%置信区间 1.08 至 1.91）和近期严重人身伤害或疾病（OR 1.40，95%置信区间 1.13 至 1.72）。具有和蔼可亲的个性略有保护作用（OR 0.91，95%置信区间 0.83 至 1.00）。按性别分层后，我们发现，在区域工作、低自我生活满意度和未能实现工作与生活平衡预测了男性医生而非女性医生的医疗过失索赔。然而，每周工作时间超过部分时间和最近有个人伤害或疾病则预测了女性医生而非男性医生的医疗过失索赔。年龄增长预测男性医生的索赔风险更高。个性类型预测了男女医生的索赔。
在澳大利亚，可改变的风险因素会增加医生发生医疗过失索赔的风险。创造更具支持性的工作环境，并针对改善医生健康和幸福感的干预措施，可能会降低医疗过失索赔的风险，并有助于提高患者安全性。
