An Examination of Medical Malpractice Claims Involving Physician Trainees.
Case-Control Studies
Databases, Factual
Dentistry
/ statistics & numerical data
Education, Medical, Graduate
Emergency Service, Hospital
/ statistics & numerical data
Gynecology
/ statistics & numerical data
Humans
Insurance, Liability
/ statistics & numerical data
Internship and Residency
Liability, Legal
Malpractice
/ statistics & numerical data
Medical Errors
Multivariate Analysis
Obstetrics
/ statistics & numerical data
Surgery, Oral
/ statistics & numerical data
Journal
Academic medicine : journal of the Association of American Medical Colleges
ISSN: 1938-808X
Titre abrégé: Acad Med
Pays: United States
ID NLM: 8904605
Informations de publication
Date de publication:
08 2020
08 2020
Historique:
pubmed:
14
12
2019
medline:
29
9
2020
entrez:
14
12
2019
Statut:
ppublish
Résumé
To identify patient-, provider-, and claim-related factors of medical malpractice claims in which physician trainees were directly involved in the harm events. The authors performed a case-control study using medical malpractice claims closed between 2012-2016 and contributed to the Comparative Benchmarking System database by teaching hospitals. Using the service extender flag, they classified claims as cases if physician trainees were directly involved in the harm events. They classified claims as controls if they were from the same facilities, but trainees were not directly involved in the harm events. They performed multivariable regression with predictor variables being patient and provider characteristics. The outcome was physician trainee involvement in harm events. From the original pool of 30,973 claims, there were 581 cases and 2,610 controls. The majority of cases involved residents (471, 81%). Cases had a statistically significant higher rate of having a trainee named as defendants than controls (184, 32% vs 233, 9%; P < .001). The most common final diagnosis for cases was puncture or laceration during surgery (62, 11%). Inadequate supervision was a contributing factor in 140 (24%) cases overall, with the majority (104, 74%) of these claims being procedure related. Multivariable regression analysis revealed that trainees were most likely to be involved in harm events in specialties such as oral surgery/dentistry and obstetrics-gynecology (OR = 7.99, 95% CI 2.93, 21.83 and OR = 1.85, 95% CI 1.24, 2.66, respectively), when performing procedures (OR = 1.58, 95% CI 1.27, 1.96), or when delivering care in the emergency room (OR = 1.65, 95% CI 1.43, 1.91). Among claims involving physician trainees, procedures were common and often associated with inadequate supervision. Training directors of surgical specialties can use this information to improve resident supervision policies. The goal is to reduce the likelihood of future harm events.
Identifiants
pubmed: 31833853
doi: 10.1097/ACM.0000000000003117
pii: 00001888-202008000-00043
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1215-1222Références
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