Factors and impact of physicians' diagnostic errors in malpractice claims in Japan

Autor: Kaori Kono, Hideyuki Kanda, Nobuhiro Nagai, Takashi Watari, Shohei Mitsuhashi, Kazuya Otuki, Yasuharu Tokuda, Kazumichi Onigata
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Critical Care and Emergency Medicine
Pulmonology
Economics
Health Care Providers
Social Sciences
Pediatrics
Geographical Locations
Medical Conditions
0302 clinical medicine
Japan
Interquartile range
Malpractice
Medicine and Health Sciences
Medical Personnel
030212 general & internal medicine
Medical diagnosis
Child
Multidisciplinary
Middle Aged
Professions
Infectious Diseases
Medicine
Female
Anatomy
Abnormality
Emergency Service
Hospital
Research Article
Adult
medicine.medical_specialty
Asia
Adolescent
Science
MEDLINE
Indemnity
Respiratory Disorders
03 medical and health sciences
Health Economics
Diagnostic Medicine
Physicians
Internal Medicine
medicine
Humans
Diagnostic Errors
business.industry
Biology and Life Sciences
Odds ratio
medicine.disease
Health Care
Gastrointestinal Tract
Upper respiratory tract infection
People and Places
Respiratory Infections
Emergency medicine
Population Groupings
business
Surgery Department
Hospital
Digestive System
030217 neurology & neurosurgery
Zdroj: PLoS ONE
PLoS ONE, Vol 15, Iss 8, p e0237145 (2020)
ISSN: 1932-6203
Popis: BackgroundDiagnostic errors are prevalent and associated with increased economic burden; however, little is known about their characteristics at the national level in Japan. This study aimed to investigate clinical outcomes and indemnity payment in cases of diagnostic errors using Japan's largest database of national claims.MethodsWe analyzed characteristics of diagnostic error cases closed between 1961 and 2017, accessed through the national Japanese malpractice claims database. We compared diagnostic error-related claims (DERC) with non-diagnostic error-related claims (non-DERC) in terms of indemnity, clinical outcomes, and factors underlying physicians' diagnostic errors.ResultsAll 1,802 malpractice claims were included in the analysis. The median patient age was 33 years (interquartile range = 10-54), and 54.2% were men. Deaths were the most common outcome of claims (939/1747; 53.8%). In total, 709 (39.3%, 95% CI: 37.0%-41.6%) DERC cases were observed. The adjusted total billing amount, acceptance rate, adjusted median claims payments, and proportion of deaths were significantly higher in DERC than non-DERC cases. Departments of internal medicine and surgery were 1.42 and 1.55 times more likely, respectively, to have DERC cases than others. Claims involving the emergency room (adjusted odds ratio [OR] = 5.88) and outpatient office (adjusted OR = 2.87) were more likely to be DERC than other cases. The initial diagnoses most likely to lead to diagnostic error were upper respiratory tract infection, non-bleeding digestive tract disease, and "no abnormality."ConclusionsCases of diagnostic errors produced severe patient outcomes and were associated with high indemnity. These cases were frequently noted in general exam and emergency rooms as well as internal medicine and surgery departments and were initially considered to be common, mild diseases.
Databáze: OpenAIRE
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