Malpractice risk according to physician specialty.
Malpractice risk according to physician specialty.
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DOI：
10.1056/nejmsa1012370
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发表时间：
2011-08-18
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影响因子：
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通讯作者：
Chandra A
中科院分区：
文献类型：
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作者：
Jena AB;Seabury S;Lakdawalla D;Chandra A
缺乏关于一年内面临医疗事故索赔的医生比例、索赔规模以及按专业划分的累积职业医疗事故风险的数据。我们分析了从1991年到2005年的所有医生的医疗事故数据，这些医生都是由一家大型专业责任保险公司承保的，该保险公司拥有全国性的客户群（40，916名医生和233，738名医生-年）。对于25个专科，我们报告了一年内发生医疗事故索赔的医生比例，导致赔偿金（支付给原告的赔偿金）的索赔比例，以及赔偿金的规模。我们估计了高风险和低风险专科医生被起诉的累积风险。在研究期间，每年有7.4%的医生有医疗事故索赔，1.6%的医生有导致付款的索赔（即，所有索赔中有78%没有向索赔人付款）。每年面临索赔的医生比例从神经外科的19.1%、胸心血管外科的18.9%和普通外科的15.3%到家庭医学的5.2%、儿科的3.1%和精神病学的2.6%不等。平均赔偿金额为274，887美元，中位数为111，749美元。平均支付额从皮肤科的117 832美元到儿科的520 923美元不等。据估计，到65岁时，75%的低风险专科医生面临医疗事故索赔，而高风险专科医生的比例为99%。医疗事故诉讼的可能性和不同专业的赔偿金额存在很大差异。在所有专业中，面临医疗事故索赔的累积风险都很高，尽管大多数索赔不会导致向原告付款。（由兰德民事司法研究所和国家老龄化研究所资助。）
Data are lacking on the proportion of physicians who face malpractice claims in a year, the size of those claims, and the cumulative career malpractice risk according to specialty. We analyzed malpractice data from 1991 through 2005 for all physicians who were covered by a large professional liability insurer with a nationwide client base (40,916 physicians and 233,738 physician-years of coverage). For 25 specialties, we reported the proportion of physicians who had malpractice claims in a year, the proportion of claims leading to an indemnity payment (compensation paid to a plaintiff), and the size of indemnity payments. We estimated the cumulative risk of ever being sued among physicians in high- and low-risk specialties. Each year during the study period, 7.4% of all physicians had a malpractice claim, with 1.6% having a claim leading to a payment (i.e., 78% of all claims did not result in payments to claimants). The proportion of physicians facing a claim each year ranged from 19.1% in neurosurgery, 18.9% in thoracic–cardiovascular surgery, and 15.3% in general surgery to 5.2% in family medicine, 3.1% in pediatrics, and 2.6% in psychiatry. The mean indemnity payment was $274,887, and the median was $111,749. Mean payments ranged from $117,832 for dermatology to $520,923 for pediatrics. It was estimated that by the age of 65 years, 75% of physicians in low-risk specialties had faced a malpractice claim, as compared with 99% of physicians in high-risk specialties. There is substantial variation in the likelihood of malpractice suits and the size of indemnity payments across specialties. The cumulative risk of facing a malpractice claim is high in all specialties, although most claims do not lead to payments to plaintiffs. (Funded by the RAND Institute for Civil Justice and the National Institute on Aging.)