M Panella1, C Rinaldi2, F Leigheb1, C Donnarumma1, S Kul3, K Vanhaecht4, F Di Stanislao5. 1. Department of Translational Medicine, School of Medicine, University of Eastern Piedmont, Novara, Italy. 2. Department of Translational Medicine, School of Medicine, University of Eastern Piedmont, Novara, Italy. Electronic address: cml.rinaldi@gmail.com. 3. Center for Applied Medical Statistics. University of Gaziantep, Gaziantep, Turkey. 4. Center for Health Services and Nursing Research, School of Public Health, University of Leuven, Leuven, Belgium. 5. Biomedical Sciences and Public Health, Università Politecnica delle Marche, Ancona, Italy.
Abstract
BACKGROUND: Defensive medicine affects healthcare systems worldwide. The concerns and perception about medical liability could lead practitioners to practise defensive medicine. Second victim is a healthcare worker involved in an unanticipated adverse patient event. The role of being second victim and the other possible determinants for defensive medicine is mostly unclear. OBJECTIVE: To study the condition of being second victim as a possible determinants of defensive medicine among Italian hospital physicians. DESIGN, SETTING AND PARTICIPANTS: A secondary analysis of the database of the national survey study on the prevalence and the costs of defensive medicine in Italy that was carried out between April 2014 and June 2014 in 55 Italian hospitals was performed for this study. The demographic section of the questionnaire was selected including the physician's age, gender, specialty, activity volume, grade and the variable being a second victim after an adverse event. RESULTS: A total sample of 1313 physicians (87.5% response rate) was used in the data analyses. Characteristics of the participants included a mean age 49.2 of years and 19.4 average years of experience. The most prominent predictor for practising defensive medicine was the physicians' experience of being a second victim after an adverse event (OR=1.88; 95%CI, 1.38-2.57). Other determinants included age, years of experience, activity volume and risk of specialty. CONCLUSIONS: Malpractice reform, effective support to second victims in hospitals together with a systematic use of evidence-based clinical guidelines, emerged as possible recommendations for reducing defensive medicine.
BACKGROUND: Defensive medicine affects healthcare systems worldwide. The concerns and perception about medical liability could lead practitioners to practise defensive medicine. Second victim is a healthcare worker involved in an unanticipated adverse patient event. The role of being second victim and the other possible determinants for defensive medicine is mostly unclear. OBJECTIVE: To study the condition of being second victim as a possible determinants of defensive medicine among Italian hospital physicians. DESIGN, SETTING AND PARTICIPANTS: A secondary analysis of the database of the national survey study on the prevalence and the costs of defensive medicine in Italy that was carried out between April 2014 and June 2014 in 55 Italian hospitals was performed for this study. The demographic section of the questionnaire was selected including the physician's age, gender, specialty, activity volume, grade and the variable being a second victim after an adverse event. RESULTS: A total sample of 1313 physicians (87.5% response rate) was used in the data analyses. Characteristics of the participants included a mean age 49.2 of years and 19.4 average years of experience. The most prominent predictor for practising defensive medicine was the physicians' experience of being a second victim after an adverse event (OR=1.88; 95%CI, 1.38-2.57). Other determinants included age, years of experience, activity volume and risk of specialty. CONCLUSIONS: Malpractice reform, effective support to second victims in hospitals together with a systematic use of evidence-based clinical guidelines, emerged as possible recommendations for reducing defensive medicine.
Keywords:
Costes sanitarios; Defensive medicine; Health care costs; Medical malpractice; Medicina defensiva; Negligencia médica; Second victim; Segunda víctima
Authors: Carmela Rinaldi; Matteo Ratti; Sophia Russotto; Deborah Seys; Kris Vanhaecht; Massimiliano Panella Journal: Int J Environ Res Public Health Date: 2022-09-26 Impact factor: 4.614