Provider and Practice Factors Associated With Emergency Physicians' Being Named in a Malpractice Claim.
Provider and Practice Factors Associated With Emergency Physicians' Being Named in a Malpractice Claim.
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提供者和实践因素与紧急医生在渎职索赔中命名。
DOI：
10.1016/j.annemergmed.2017.06.023
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发表时间：
2018-03
影响因子：
6.2
通讯作者：
Venkat A
中科院分区：
文献类型：
--
作者：
Carlson JN;Foster KM;Pines JM;Corbit CK;Ward MJ;Hydari MZ;Venkat A
我们研究了急诊医生特征和实践因素与在医疗事故索赔中被点名的风险之间的关联。我们使用医疗事故索赔以及来自国家急诊医学小组（2010 年 1 月 1 日至 2014 年 6 月 30 日期间 15 个州的 87 个急诊科 (ED)）的提供者、运营和管辖数据来评估个体医生与实践变量以及医疗事故索赔中的命名之间的关系。个人和实践因素包括：实践年限、急诊医学委员会认证、就诊率、产生的相对价值单位/小时、作为记录主治医生的总就诊次数、在多个机构工作、主要夜班工作、患者体验数据百分位数以及州医疗事故环境。我们使用逻辑回归评估了急诊医生与实践变量和医疗事故索赔之间的关系。在 1,029 名急诊医生就诊的 9,477,150 次急诊就诊中，90 名医生 (9%) 收到了 98 起医疗事故索赔。执业总年数的增加（调整后的比值比 1.04，95% CI 1.02–1.06）和就诊量的增加（调整后的比值比为每 1000 次就诊 1.09，95% CI 1.05–1.12）与在医疗事故索赔中被点名相关。没有其他因素与医疗事故索赔相关。在这份急诊医生样本中，十分之一的人在超过 4.5 年的医疗事故索赔中被点名。执业总年数和就诊量是唯一确定的与被命名相关的因素，这表明接触更多患者和更长的执业经验是造成医疗事故风险的主要因素。
We examine the association between emergency physician characteristics and practice factors with the risk of being named in a malpractice claim. We used malpractice claims along with provider, operational, and jurisdictional data from a national emergency medicine group (87 emergency departments (EDs) in 15 states from 1/1/2010 to 6/30/2014) to assess the relationship between individual physician and practice variables and being named in a malpractice claim. Individual and practice factors included: years in practice, emergency medicine Board Certification, visit admission rate, Relative Value Units/hour generated, total visits seen as attending physician of record, working at multiple facilities, working primarily overnight shifts, patient experience data percentile, and state malpractice environment. We assessed the relationship between emergency physician and practice variables and malpractice claims using logistic regression. In 9,477,150 ED visits seen by 1,029 emergency physicians, there were 98 malpractice claims against 90 physicians (9%). Increasing total number of years in practice (adjusted odds ratio 1.04, 95% CI 1.02–1.06) and higher visit volume (adjusted odds ratio 1.09 per 1000 visits, 95% CI 1.05–1.12) were associated with being named in a malpractice claim. No other factors were associated with malpractice claims. In this sample of emergency physicians, one in 11 were named in a malpractice claim over 4.5 years. Total number of years in practice and visit volume were the only identified factors associated with being named, suggesting that exposure to higher patient volumes and longer practice experience are the primary contributors to malpractice risk.
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DOI：
10.1377/hlthaff.2009.0807
发表时间：
2010-09
期刊：
Health affairs (Project Hope)
影响因子：
--
作者：
Mello MM;Chandra A;Gawande AA;Studdert DM
通讯作者：
Studdert DM
DOI：
10.1056/nejmsa1012370
发表时间：
2011-08-18
期刊：
The New England journal of medicine
影响因子：
--
作者：
Jena AB;Seabury S;Lakdawalla D;Chandra A
通讯作者：
Chandra A
影响因子：
158.5
作者：
Studdert, David M.;Bismark, Marie M.;Spittal, Matthew J.
通讯作者：
Spittal, Matthew J.
影响因子：
120.7
作者：
Hickson, GB;Federspiel, CF;Bost, P
通讯作者：
Bost, P
影响因子：
6.2
作者：
Abualenain, Jameel;Frohna, William J.;Pines, Jesse M.
通讯作者：
Pines, Jesse M.