defensive medicine in israel – a nationwide survey防御性医疗在以色列u2014u2014一个全国性的调查.pdfVIP

Defensive Medicine in Israel – A Nationwide Survey 1 2 3 2 2 Elad Asher *, Sari Greenberg-Dotan , Jonathan Halevy , Shimon Glick , Haim Reuveni 1 Sheba Medical Center, Tel Hashomer, Ramat-Gan, Israel, 2 Ben-Gurion University of the Negev, Beer-Sheva, Israel, 3 Shaare Zedek Medical Center, Jerusalem, Israel Abstract Background: Defensive medicine is the practice of diagnostic or therapeutic measures conducted primarily as a safeguard against possible malpractice liability. We studied the extent, reasons, and characteristics of defensive medicine in the Israeli health care system. Methods and Findings: Cross-sectional study performed in the Israeli health care system between April and July 2008 in a sample (7%) of board certified physicians from eight medical disciplines (internal medicine, pediatrics, general surgery, family medicine, obstetrics and gynecology, orthopedic surgery, cardiology, and neurosurgery). A total of 889 physicians (7% of all Israeli board certified specialists) completed the survey. The majority [60%, (95%CI 0?57–0?63)] reported practicing defensive medicine; 40% (95%CI 0?37–0?43) consider every patient as a potential threat for a medical lawsuit; 25% (95%CI 0?22–0?28) have previously been sued at least once during their career. Independent predictors for practicing defensive medicine were surgical specialty [OR = 1.6 (95%CI 1?2–2?2), p = 0?0004], not performing a fellowship abroad [OR = 1?5 (95%CI 1?1–2), p = 0?027], and previous exposure to lawsuits [OR = 2?4 (95%CI 1 ?7–3?4), p ,0?0001]. Independent predictors for the risk of being sued during a physician’s career were male gender [OR = 1?6 (95%CI 1?1–2?2), p = 0?012] and surgery specialty [OR = 3?2 (95%CI 2?4–4 ?3), p ,0?0001] (general surgery, obstetrics and