Bovbjerg R R, Dubay L C, Kenney G M, Norton S A
J Health Polit Policy Law. 1996 Summer;21(2):267-88. doi: 10.1215/03616878-21-2-267.
Quantitative analysis of medical liability's influence on medical practice is a small but growing field. The three foregoing articles illustrate three of the possible analytic approaches: case study of technological diffusion, survey of physician responses to detailed clinical scenarios, and multivariate analysis of the relation of physicians' scenario responses to objective liability experience. The articles also offer a good picture of the state of the art: Many difficulties hamper research in this area, and these articles, like others, offer considerable illumination but leave much uncovered. Defensive medicine surely exists, but its effects on health care spending and access are unclear. The most important lessons for public policy are that tort reform may be necessary but not sufficient to reduce the problems associated with defensive medicine, and that the major malpractice problem continues to be malpractice.
对医疗责任对医疗实践影响的定量分析是一个规模虽小但不断发展的领域。上述三篇文章阐述了三种可能的分析方法：技术传播的案例研究、医生对详细临床情景反应的调查，以及医生情景反应与客观责任经历关系的多变量分析。这些文章还很好地展现了当前的技术水平：该领域的研究面临诸多困难，这些文章与其他文章一样，虽提供了相当多的启示，但仍有许多未涉及的内容。防御性医疗肯定存在，但其对医疗保健支出和可及性的影响尚不清楚。对公共政策而言，最重要的教训是侵权法改革可能有必要，但不足以减少与防御性医疗相关的问题，而且主要的医疗事故问题仍然是医疗事故。
