THE IMPACT OF LITIGATION RISK ON CESAREAN SECTION RATES

20世纪80年代的S见证了剖宫产率和剖宫产率的急剧上升 产科医生和家庭医生的医疗事故保险费。 尽管一些评论员将剖腹产率较高的部分原因归因于 防御性医学，没有研究试图测试所谓的 使用大数据集和控制风险因素进行关联。这个 医疗实践研究小组收集了计算机化的医院出院信息 1984年纽约州四分之一的住院人数数据和 几乎完整的医疗事故索赔数据，针对医院和 医生。此外，它还审查了31,000个概率样本 来自51家医院的记录，以获取不良反应发生率的信息 1984年在纽约州医院发现的事件。使用这些数据， 该小组建议检验这样一种假设，即较高的诉讼风险 产科护理提供者面临的风险与较高的剖宫产率有关 费率。拟议的分析将控制已知的临床风险因素。 并调整剖腹产变异的其他可能解释 费率。

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.