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在住院和门诊机构的不良事件中支付过失医疗索赔
Tara F Bishop1, Andrew M Ryan, Andrew K Ryan
1Division of Outcomes and Effectiveness, Department of Public Health, Weill Cornell Medical College, New York, New York 10021, USA. tlfernan@med.cornell.edu
JAMA
|June 16, 2011
概括
门诊病例的付费医疗失误索赔几乎与住院病例一样普遍,诊断错误是门诊病例的主要原因. 住院患者索赔的平均付款高于门诊患者索赔.
科学领域:
- 医疗疏忽诉讼 医疗疏忽诉讼 医疗疏忽诉讼
- 医疗保健的质量和安全.
- 医疗服务研究 医疗服务研究
背景情况:
- 对付费的医疗失误索赔的分析提供了对不良医疗事件的见解.
- 了解医疗错误的情况对于提高患者安全至关重要.
研究的目的:
- 为了比较住院和门诊之间支付的医疗疏忽索赔的数量,规模和类型.
- 识别医疗失误索赔的趋势和促成因素.
主要方法:
- 从国家执业医师数据库 (2005-2009) 获得的支付失职索赔的回顾性分析.
- 评估索赔特征,支付金额,错误类型,以及根据设置 (住院患者与门诊患者) 的结果.
主要成果:
- 2009年,门诊病人的索赔占有43.1%的付款失职索赔,类似于住院病人的索赔 (47.6%).
- 诊断错误是门诊索赔 (45.9%) 的最常见原因,而在住院索赔中,外科错误占主导地位 (34.1%).
- 在这两种情况下,重大伤害和死亡是常见的结果,与门诊事件相比,住院事件的平均支付高 (362,965美元) 和门诊事件的平均支付高 (290,111美元).
结论:
- 门诊事件支付的医疗失误索赔的数量与住院事件相当.
- 诊断错误是改善门诊护理安全的一个重要领域.
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