患者的行为是否促使医生从事防御医学? 来自视频实验的证据
1Faculty of Business Economics, Hasselt University, Martelarenlaan 42, 3500, Hasselt, Belgium. lotte.daniels@uhasselt.be.
Health economics review
|September 22, 2023
概括
当医生认为被起诉的风险更高时,他们会采取更具防御性的医疗行为. 患者的批判态度增加了这种感知到的责任风险,影响了医疗决策.
科学领域:
- 医疗法律和伦理学
- 临床实践和决策过程
- 患者与医生的沟通 患者与医生的沟通
背景情况:
- 医生可能会从事防御性医学,执行不必要的程序以减轻失误的风险.
- 患者的行为和沟通方式可以影响医生对责任的看法.
- 了解这些动态对于改善医疗保健质量和降低成本至关重要.
研究的目的:
- 调查患者的批评态度是否会增加医生的责任感风险.
- 为了确定这种增加的风险是否导致更具防御性的医疗实践.
- 在比利时的背景下,为妇科医生/产科医生和整形外科医生研究这种关系.
主要方法:
- 85名执业医生 (妇科医生/产科医生和整形外科医生) 被随机分配观看四个视频咨询中的一个.
- 患者参与者表现出一种批判性或非批判性的态度.
- 医生报告了他们预期的治疗和被起诉的概率.
主要成果:
- 患者的批判性态度显著增加了医生的责任感风险.
- 当医生面临高负责任风险时,他们采取了17%的防御行动.
- 这种效应在控制医生沟通,患者临床情况和非语言线索的同时观察到.
结论:
- 患者的批判性态度是医生认为的责任风险的关键驱动因素.
- 这种感知到的风险直接影响医生从事防御性医疗行为.
- 研究结果强调了患者互动对医疗决策和资源利用的影响.
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