医生失职索赔率与低风险胸痛入院率的关联
James Quinn1, Sukyung Chung2, David Kim3
1Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, United States.
American journal of medicine open
|July 22, 2024
概括
较高的医疗失误索赔率与低风险胸痛患者的住院人数增加有关,这表明急诊室的防御医学实践. 这种趋势导致不必要的住院费用显著增加.
科学领域:
- 紧急医疗 紧急医疗
- 卫生政策 卫生政策
- 医疗不当行为 医疗不当行为
背景情况:
- 胸部疼痛是急诊室 (ED) 常见的访问原因,为医生高额的医疗失误赔偿作出了贡献.
- 防御性药物,受到误诊风险的影响,可能会影响临床决策.
研究的目的:
- 调查低风险胸痛 (LRCP) 患者的医院住院率与医疗失误索赔率之间的关联.
- 为了确定医生判断是关键的条件,是否有误诊率影响入院决策.
主要方法:
- 使用州级数据进行了10年 (2008-2017年) 的横截面时间序列分析.
- 检查了医疗失误索赔率 (MPCRs) 与LRCP和急性心肌梗塞 (AMI) 的入院率作为对照.
- 利用国家固定效应模型来分析这种关联,调整通货膨胀.
主要成果:
- 增加MPCR与LRCP入院率上升3.66%有关.
- 在MPCR和AMI入院率之间没有发现显著的关联,这表明对需要医生自由裁量权的条件的特异性.
- 在16.6%的患者中,LRCP的入院发生在16.6%的患者中,平均成本为17.120美元.
结论:
- 较高的医疗失误索赔率与较高的低风险胸痛入院率有关.
- 这种联系表明,防御医学可能会导致不必要的住院治疗,从而导致大量的医疗保健费用.
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