Entman S S, Glass C A, Hickson G B, Githens P B, Whetten-Goldstein K, Sloan F A
Department of Obstetrics and Gynecology, Vanderbilt University Medical Center Nashville, TN.
JAMA. 1994;272(20):1588-91.
To determine the relationship between prior malpractice claims experience and the quality of clinical obstetric care.
Historical cohort study of obstetricians, classified by their prior malpractice claims experience, with blinded review of medical records from their practices 5 to 10 years later.
Florida obstetricians who lost, settled, or defended malpractice claims between 1977 and 1983 and who were still practicing obstetrics in 1987.
Objective and subjective assessment of quality of clinical care of patients attended by obstetricians with different histories of malpractice claims.
No differences were found in any of the objective or subjective measures of the quality of clinical care provided to patients of obstetricians who were classified into one of four groups according to their prior claims history.
No relationship was found between prior malpractice claims experience and the technical quality of practice by Florida obstetricians. Strategies that attempt to identify physicians at risk for future clinical errors by using data on prior malpractice claims (such as the National Practitioner Data Bank) may be misjudging the likelihood that substandard clinical care will be provided by physicians with prior claims.
确定既往医疗事故索赔经历与临床产科护理质量之间的关系。
对产科医生进行历史性队列研究，根据他们既往的医疗事故索赔经历进行分类，并在5至10年后对其医疗记录进行盲法审查。
1977年至1983年间有医疗事故索赔败诉、和解或辩护经历且在1987年仍从事产科工作的佛罗里达州产科医生。
对有不同医疗事故索赔历史的产科医生所诊治患者的临床护理质量进行客观和主观评估。
根据既往索赔历史分为四组的产科医生，在为其患者提供的临床护理质量的任何客观或主观指标上均未发现差异。
未发现既往医疗事故索赔经历与佛罗里达州产科医生的执业技术质量之间存在关联。试图通过使用既往医疗事故索赔数据（如国家从业者数据库）来识别未来有临床失误风险的医生的策略，可能会错误判断有既往索赔经历的医生提供不合格临床护理的可能性。
