THE IMPACT OF LITIGATION RISK ON CESAREAN SECTION RATES

20世纪80年代，剖宫产率急剧上升， 产科医生和家庭医生的医疗事故保险费。 尽管一些评论者将较高的剖宫产率部分归因于 防御性医学，没有研究试图测试所谓的 关联使用大数据集和控制风险因素。的 医疗实践研究小组收集了计算机化的出院记录 1984年纽约州四分之一的住院病人的数据， 几乎完整的针对医院的医疗事故索赔数据， 医生此外，它还审查了31，000个概率样本， 从51家医院的记录，以获得不良事件的发生率信息 1984年在纽约州立医院发现的事件。利用这些数据， 专家组建议检验一个假设，即诉讼风险越高， 产科护理提供者面临的风险与剖宫产率较高有关 rates.拟定的分析将控制已知的临床风险因素 并对剖宫产率变化的其他可能解释进行调整 rates.

The 1980's have witnessed a dramatic increase in cesarean section rates and medical malpractice premiums for obstetricians and family practitioners. Although some commentators attribute part of the higher cesarean rates to defensive medicine, no study has attempted to test the purported association using large data sets and controlling for risk factors. The Medical Practice Study Group has collected computerized hospital discharge data for one-quarter of the hospitalizations in New York State in 1984 and virtually complete malpractice claims data on actions against hospitals and physicians. In addition, it has reviewed a probability sample of 31,000 records from 51 hospitals to obtain information on the incidence of adverse events discovered in New York State hospitals in 1984. Using these data, the Group proposes to test the hypothesis that a higher risk of litigation faced by providers of obstetrical care is associated with higher cesarean rates. The proposed analysis will control for known clinical risk factors and adjust for other possible explanations for variations in cesarean rates.