Elnicki R A, Schmitt J P
Health Serv Res. 1980 Winter;15(4):397-414.
The 1974 medical malpractice "crisis" brought about extensive legislation and insurance regulation in the United States. Hospitals in many states are now required to support risk management programs that include investigation and systematic analyses of adverse patient incidents. However, no research supports the hypothesis that systematic analysis of adverse patient incidents can identify contributory factors. In this study, a simple prediction model was used to estimate relationships between adverse incidents and selected patient and environmental characteristics in a large hospital. While some of the incident-characteristic relationships were significant, none of the estimated equations yielded results that could be logically translated into policy recommendations for the hospital. These results point to the need for further research. The benefits that positive research results would have for patients, hospitals, an the bill-paying public are obvious. Additional negative results would suggest that many legislative bodies and regulatory agencies were presumptions in requiring hospitals to conduct analyses of incidents.
1974年的医疗事故“危机”在美国引发了广泛的立法和保险监管。现在许多州要求医院支持风险管理项目，其中包括对不良患者事件进行调查和系统分析。然而，没有研究支持对不良患者事件进行系统分析能够识别促成因素这一假设。在本研究中，使用了一个简单的预测模型来估计一家大型医院中不良事件与选定的患者及环境特征之间的关系。虽然一些事件与特征之间的关系具有显著性，但所估计的方程中没有一个得出的结果能够合理地转化为针对该医院的政策建议。这些结果表明有必要进行进一步研究。积极的研究结果将给患者、医院和付费公众带来的益处是显而易见的。更多的负面结果则表明许多立法机构和监管机构在要求医院对事件进行分析方面是主观臆断的。
