Reynolds R A, Rizzo J A, Gonzalez M L
JAMA. 1987;257(20):2776-81.
The high cost of medical professional liability is a source of growing concern among policymakers, health care consumers, and the medical profession. While the concern is widespread, to date there has been little quantitative evidence on the overall economic impact of the problem. Utilizing data from the American Medical Association's Socioeconomic Monitoring System, the impact of medical professional liability (PL) on the cost of physicians' services has been estimated employing two different methods. Both estimates indicate that the costs of PL are substantial. In particular, the two methods yield estimates of the total cost of PL in 1984 of $13.7 and $12.1 billion, respectively--or approximately 15% of the total expenditures on physicians' services. Furthermore, increased costs associated with PL from 1983 to 1984 alone are estimated under the two methods to have accounted for 63% and 57%, respectively, of the increase in expenditures on physicians' services. These costs include PL insurance premiums, costs of practice changes made in response to increasing PL risk, and costs of incurring claims that are not covered by PL insurance.
医疗职业责任保险的高昂成本日益引起政策制定者、医疗保健消费者和医疗行业的关注。尽管这种担忧普遍存在，但迄今为止，几乎没有关于该问题总体经济影响的量化证据。利用美国医学协会社会经济监测系统的数据，采用两种不同方法估算了医疗职业责任（PL）对医生服务成本的影响。两种估算均表明，PL成本相当可观。具体而言，这两种方法得出的1984年PL总成本估算分别为137亿美元和121亿美元，约占医生服务总支出的15%。此外，仅从1983年到1984年，根据这两种方法估算，与PL相关的成本增加分别占医生服务支出增加额的63%和57%。这些成本包括PL保险费、因PL风险增加而进行的业务变更成本，以及PL保险未涵盖的索赔成本。
