Hickson G B, Clayton E W, Entman S S, Miller C S, Githens P B, Whetten-Goldstein K, Sloan F A
Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.
JAMA. 1994;272(20):1583-7.
To examine the relationship between prior physician malpractice experience and patients' satisfaction with care.
Women were interviewed using a questionnaire that contained structured and open-ended questions.
Mothers of all stillborn infants, infant deaths, and a random sampling of viable infants drawn from 1987 Florida Vital Statistics were sorted into four groups based on the malpractice claims experience of their obstetricians between 1983 and 1986. Interviews were completed with 963 of 1536 women, most by telephone, 53 by in-person interview.
Mothers' responses to closed-ended and open-ended questions about their perceptions of the care they received during their pregnancy, labor, and delivery.
Even though none of the women actually filed a claim, a consistent pattern of differences emerged when comparing women's perceptions of care received. Patients seeing physicians with the most frequent numbers of claims but without high payments were significantly more likely to complain that they felt rushed, never received explanations for tests, and were ignored. In response to the open-ended question, "What part of your care were you least satisfied with?" women seeing physicians in the High Frequency malpractice risk group offered twice as many complaints as those seeing physicians who had never been sued. Problems with physician-patient communication were the most commonly offered complaints.
Physicians who have been sued frequently are more often the objects of complaints about the interpersonal care they provide even by their patients who do not sue.
探讨医生既往医疗事故经历与患者护理满意度之间的关系。
采用包含结构化和开放式问题的问卷对女性进行访谈。
从1987年佛罗里达州生命统计数据中抽取的所有死产婴儿母亲、婴儿死亡母亲以及存活婴儿的随机样本,根据其产科医生在1983年至1986年间的医疗事故索赔经历分为四组。对1536名女性中的963名进行了访谈,大多数通过电话进行,53名通过面对面访谈。
母亲们对关于她们在怀孕、分娩和生产期间所接受护理认知的封闭式和开放式问题的回答。
尽管没有一位女性实际提出索赔,但在比较女性对所接受护理的认知时,出现了一致的差异模式。看诊有最多索赔次数但赔付不高的医生的患者,更有可能抱怨感觉匆忙、从未得到检查解释且被忽视。针对开放式问题“你对护理中哪部分最不满意?”,处于高频率医疗事故风险组的女性看诊医生的抱怨是从未被起诉医生的两倍。医患沟通问题是最常提出的抱怨。
即使是未起诉的患者,经常被起诉的医生也更常成为其对所提供人际护理抱怨的对象。