Physician and public opinions on quality of health care and the problem of medical errors.
Physician and public opinions on quality of health care and the problem of medical errors.
复制标题
医生和公众对医疗保健质量和医疗差错问题的看法。
DOI：
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发表时间：
2002
影响因子：
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通讯作者：
R. Anderson
中科院分区：
文献类型：
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作者：
Andrew R Robinson;K. Hohmann;Julie I Rifkin;D. Topp;C. Gilroy;Jeffrey A Pickard;R. Anderson
背景
1999年医学研究所关于医疗差错的报告提出了对医疗保健系统的重大改革，并获得了媒体的广泛关注，但关于医生或公众对该报告建议的意见的信息有限。
方法
对1000名科罗拉多医生（n = 594）和1000名国家医生（n = 304）进行邮件调查，并对500户科罗拉多家庭进行电话调查，以评估与1999年医学研究所报告中的几项建议和结论的一致性。
结果
大多数医生认为，减少医疗差错应该是国家的优先事项（69.7%的科罗拉多医生）。然而，医生比公众更不可能相信护理质量是一个问题（29.1%对67.6%; P<.001）或需要一个国家机构来解决医疗差错问题（24.1%对59.8%; P<.001）。医生们一致认为，对医疗事故的恐惧是报告错误的一个障碍，更大的法律的保障是强制性报告制度成功的必要条件。几乎所有的医生（92.9%）认为，需要更多的培训，如何处理医疗差错，60.1%的同意，这是很难区分的错误，由于疏忽和意外的错误。
结论
医生们似乎对医疗差错普遍感到担忧，但在这次调查中，只有少数人认为这个问题与医学研究所和公众认为的一样重要。我们的研究结果表明，医生看到成功减少错误的几个障碍，包括难以定义错误，需要更多的培训，在处理错误，和担心医疗事故诉讼。解决这些障碍将是增加医生对医学研究所提出的许多变化的支持的必要步骤。
BACKGROUND
The 1999 Institute of Medicine report on medical errors proposed major changes to the health care system and gained widespread media attention, yet there is limited information on physician or public opinion regarding recommendations from that report.
METHODS
Mail survey of 1000 Colorado physicians (n = 594) and 1000 national physicians (n = 304), and telephone survey of 500 Colorado households to assess agreement with several proposals and conclusions from the 1999 Institute of Medicine report.
RESULTS
Most physicians believed that reduction of medical errors should be a national priority (69.7% of Colorado physicians). However, physicians were much less likely than the public to believe that quality of care is a problem (29.1% vs 67.6%; P<.001) or that a national agency is needed to address the problem of medical errors (24.1% vs 59.8%; P<.001). Uniformly, physicians believed that fear of medical malpractice is a barrier to reporting of errors and that greater legal safeguards are necessary for a mandatory reporting system to be successful. Nearly all physicians (92.9%) believed that more training in how to handle medical errors is needed, and 60.1% agreed that it is difficult to differentiate errors due to negligence from unintended errors.
CONCLUSIONS
There appears to be widespread concern among physicians regarding medical errors, but only a minority in this survey believed that the problem is as significant as the Institute of Medicine and the public believe it to be. Our results suggest that physicians see several barriers to successful error reduction including difficulty defining errors, the need for more training in handling errors, and fear of malpractice litigation. Addressing these barriers will be a necessary step to increasing physician support for many of the changes proposed by the Institute of Medicine.