Meredith V, Cook C B, Penman A
Mississippi College School of Law, Jackson, USA.
Diabetes Care. 1998 Jul;21(7):1096-100. doi: 10.2337/diacare.21.7.1096.
To examine the available national surveillance data on malpractice claims associated with diabetes and to determine the medical specialties having the highest number of claims and the classes and costs of filed claims relating to diabetes.
Data was abstracted from the Data Sharing Reports (DSRs) of the Physicians Insurers Association of America (PIAA), as well as a search of the PIAA's computerized database for the period spanning 1 January 1985 to 31 December 1996. Data on numbers of claims, medical causes of loss, indemnity paid, demographics of claimants and physicians, severity, and medical specialties with diabetes-related claims were available.
A total of 906 diabetes claims were reported to PIAA, and the total indemnity paid was $26,892,848. A significant downward trend (P = 0.004) was noted for the period between 1993 and 1996. Diabetes claimants were older and predominantly male, relative to all claimants. Ophthalmology, internal medicine, and general and family practice had the highest rates of reported claims at 16.5, 13.6, and 13.4 diabetes claims per 1,000 claims, respectively. Of the diabetes-related injuries, 44% occurred in the practitioners office, as compared with 27% for all claims. A greater proportion of diabetes claims were associated with the highest level of severity of injury with respect to all claims compiled by the PIAA.
The database of the PIAA can be a useful resource to monitor trends in diabetes-related malpractice. Further study into whether claims result from lack of adherence to practice guidelines is needed. Prevention programs designed to reduce the liability among high-risk specialties may also lead to improved care for the patient with diabetes.
研究现有的全国性糖尿病相关医疗事故索赔监测数据，确定索赔数量最多的医学专科以及与糖尿病相关的已提交索赔的类别和成本。
数据取自美国医师保险协会（PIAA）的数据共享报告（DSR），并检索了PIAA 1985年1月1日至1996年12月31日期间的计算机数据库。可获得索赔数量、损失的医学原因、赔付金额、索赔人和医生的人口统计学数据、严重程度以及与糖尿病相关索赔的医学专科等数据。
PIAA共收到906起糖尿病相关索赔，赔付总额为26,892,848美元。1993年至1996年期间呈显著下降趋势（P = 0.004）。与所有索赔人相比，糖尿病索赔人年龄较大且男性居多。眼科、内科以及普通和家庭医学科的报告索赔率最高，分别为每1000起索赔中有16.5起、13.6起和13.4起糖尿病相关索赔。在与糖尿病相关的伤害中，44%发生在从业者办公室，而所有索赔的这一比例为27%。在PIAA汇总的所有索赔中，与糖尿病相关的索赔中因最严重伤害程度导致的比例更高。
PIAA的数据库可作为监测糖尿病相关医疗事故趋势的有用资源。需要进一步研究索赔是否源于未遵循实践指南。旨在降低高风险专科责任的预防计划也可能改善对糖尿病患者的护理。
