穷人会起诉更多吗? 一个关于不当行为索赔和社会经济地位的案例控制研究
H R Burstin1, W G Johnson, S R Lipsitz
1Division of General Medicine, Brigham and Women's Hospital, Boston, MA.
JAMA
|October 13, 1993
概括
穷人和没有保险的患者不太可能提出医疗失误索赔,即使经历了医疗伤害. 这表明,对医疗失误风险的恐惧不应该阻止医生为低收入人群服务.
科学领域:
- 医疗疏忽诉讼 医疗疏忽诉讼 医疗疏忽诉讼
- 医疗服务研究 医疗服务研究
- 医疗保健中的社会经济差异
背景情况:
- 社会经济地位 (SES) 可能会影响患者对医疗失误索赔的行为.
- 了解这些差异对于公平获得医疗保健和政策制定至关重要.
研究的目的:
- 调查社会经济地位与提出医疗疏忽索赔的风险之间的关联.
- 专门检查那些遭受医疗伤害的患者之间的这种关联.
主要方法:
- 一项病例控制研究使用了来自纽约州51家医院的数据.
- 大约31,000份医院记录被审查,以确定医疗伤害及其严重程度.
- 索赔人案件与基于伤害状况的非索赔人对照进行了匹配.
主要成果:
- 贫困患者 (OR,0.2;95% CI,0.03-0.8) 和没有保险的患者 (OR,0.1;95% CI,0.005-0.9) 提出医疗失误索赔的可能性明显较低,控制医疗伤害严重程度.
- 遭受医疗伤害的老年患者也不太可能提出索赔 (OR,0.2;95% CI,0.03-0.9).
- 没有发现性别或种族与不当行为索赔风险之间的独立关联.
结论:
- 具有较低社会经济地位 (贫困和没有保险) 的患者不太可能在医疗损伤方面提出医疗失误索赔,无论医疗损伤如何.
- 这些发现表明,对不当医疗风险的担忧不应该影响医生治疗穷人的决定.
- 这项研究质疑了旨在保护为医疗贫困人口服务的医生免受医疗不当诉讼的侵权改革的必要性.
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