Department of Economics and Business, University of Sassari, Via Muroni, 25, 07100, Sassari, Italy.
BMC Health Serv Res. 2023 Oct 17;23(1):1104. doi: 10.1186/s12913-023-10089-3.
Several studies have been carried out on defensive medicine, but research from the managerial viewpoint is still scarce. Therefore, the aim of the present study is to conduct a literature review to better understand defensive medicine from a managerial perspective.
DESIGN/METHODOLOGY/APPROACH: A literature review was conducted of studies focusing on the organisational (meso) level of healthcare providers and managerial practices. A final sample of 28 studies was processed.
Defensive medicine has mainly been studied in the USA, and scholars have principally used quantitative surveys. High-risk specialities have been a critical field of investigation, and a large portion of the papers are published in journals that cover medicine, health policy, education and law fields. The analysis showed that operations and the organisation of staffing were the most discussed managerial practices. No study considered planning and budgeting aspects.
ORIGINALITY/VALUE: The review confirmed that the managerial aspect of defensive medicine has not been fully addressed. Stimulated by this gap, this study analyses the managerial background of the defensive medicine phenomenon and shows which managerial practices have been most analysed. This paper also contributes to developing the literature on defensive medicine from the managerial side. Areas for future research include qualitative studies to investigate the behaviour of managers of healthcare companies to give a different perspective on defensive medicine and organisations' decision-making.
RESEARCH LIMITATIONS/IMPLICATIONS: Some important publications might have been missed in this work because of the choice of only two databases. A further limit could be imposed by the use of the English language as an inclusion criterion.
已经有多项关于防御性医疗的研究，但从管理角度进行的研究仍然很少。因此，本研究的目的是进行文献回顾，以便从管理角度更好地理解防御性医疗。
设计/方法/途径：对关注医疗服务提供者组织（中观）层面和管理实践的研究进行了文献回顾。最终处理了 28 项研究的样本。
防御性医疗主要在美国进行研究，学者主要使用定量调查。高风险专业一直是一个关键的研究领域，其中很大一部分论文发表在涵盖医学、卫生政策、教育和法律领域的期刊上。分析表明，运营和人员配置组织是讨论最多的管理实践。没有研究考虑到规划和预算方面。
原创性/价值：本综述证实，防御性医疗的管理方面尚未得到充分解决。受这一差距的刺激，本研究分析了防御性医疗现象的管理背景，并展示了哪些管理实践最受分析。本文还有助于从管理角度发展关于防御性医疗的文献。未来的研究领域包括定性研究，以调查医疗保健公司经理的行为，从不同角度研究防御性医疗和组织的决策。
研究局限性/影响：由于仅选择了两个数据库，因此在这项工作中可能遗漏了一些重要的出版物。另一个限制可能是使用英语作为纳入标准。
