The Impacts of Disclosure and a Proactive Compensation Offer on Chinese Patients’ Actions After Medical Errors
The Impacts of Disclosure and a Proactive Compensation Offer on Chinese Patients’ Actions After Medical Errors
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DOI：
10.1097/pts.0000000000000855
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发表时间：
2021-04
影响因子：
2.2
通讯作者：
X. Gu;Mingming Deng
中科院分区：
文献类型：
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作者：
X. Gu;Mingming Deng
补充数字内容可在文本中找到。目的本研究旨在探讨医疗差错披露和主动补偿对中国患者医疗差错行为的影响。方法采用问卷调查的方法，对915名大学生进行调查。介绍了两个涉及错误披露的虚构案例（造成中度和严重损害）。5披露和补偿类型之一，随机提供给每个参与者。这5种类型是3种披露类型（不披露、部分披露和完全披露）和2种主动补偿提议类型（不提议和提议）的组合，不披露但主动补偿提议除外。受访者被问及如果他们是受影响的患者，他们是否愿意采取行动。结果广义有序logit回归模型显示，错误披露并不增加患者采取行动的可能性，如更换医生、投诉或提起诉讼。主动赔偿降低了患者提起诉讼的意愿，但对其他行为选择没有显著影响。此外，患者的行为还受到其他因素的影响，如错误的严重程度、年龄、性别、教育水平、宗教信仰、先前的错误经历和健康保险。结论建议在我国建立“信息披露与补偿”制度。为确保这些建议得到执行，建议提供适当的培训，并改进保健机构的披露文化。此外，还需要法律或法规来管理错误披露，并为医疗保健专业人员和组织提供支持。
Supplemental digital content is available in the text. Objectives This study aims to obtain evidence of the impacts of error disclosure and the impacts of a proactive compensation offer on Chinese patients’ actions after medical errors. Methods A total of 915 responses were collected from a questionnaire survey. Two fictitious cases (entailed moderate and severe harm) that involved error disclosure were described. One of 5 disclosure and compensation types was randomly provided to each participant. The 5 types were combinations of 3 disclosure types (no disclosure, partial disclosure, and full disclosure) and 2 proactive compensation offer categories (no offer and an offer), with the exception of no disclosure but a proactive compensation offer. The respondents were asked about their willingness to take actions if they were the affected patient. Results The generalized ordinal logit regression model showed that error disclosure did not increase the likelihood of the patients taking action, such as changing physicians, complaining, or filing lawsuits. A proactive compensation offer decreased the patients’ willingness to file lawsuits but had no significant influence on the other action choices. In addition, the patients’ actions were affected by other factors, such as the severity of the error, age, sex, education level, being religious, prior error experience, and health insurance. Conclusions We suggest that “disclosure and compensation” programs are developed in China. To ensure their implementation, it is recommended that appropriate training is provided and that the disclosure culture in health care organizations is improved. Furthermore, laws or regulations are required that govern error disclosure and provide support for health care professionals and organizations.