Liability impact of the hospitalist model of care
BACKGROUND An increasingly large proportion of inpatient care is provided by hospitalists. The care discontinuities inherent to hospital medicine raise concerns about malpractice risk. However, little published data exist on the medical liability risks associated with care by hospitalists. OBJECTIVE...
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| Veröffentlicht in: | Journal of hospital medicine 2014-12, Vol.9 (12), p.750-755 |
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| container_title | Journal of hospital medicine |
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| creator | Schaffer, Adam C. Puopolo, Ann Louise Raman, Supriya Kachalia, Allen |
| description | BACKGROUND
An increasingly large proportion of inpatient care is provided by hospitalists. The care discontinuities inherent to hospital medicine raise concerns about malpractice risk. However, little published data exist on the medical liability risks associated with care by hospitalists.
OBJECTIVE
We sought to determine the risks and outcomes of malpractice claims against hospitalists in internal medicine.
DESIGN
Retrospective observational analysis.
MEASUREMENTS
Using claims data from a liability insurer‐maintained database of over 52,000 malpractice claims, we measured the rates of malpractice claims against hospitalists compared to other physician specialties, types of allegations against hospitalists, contributing factors, and the severity of injury in and outcomes of these claims.
RESULTS
Hospitalists had a malpractice claims rate of 0.52 claims per 100 physician coverage years (PCYs), which was significantly lower than that of nonhospitalist internal medicine physicians (1.91 claims per 100 PCYs), emergency medicine physicians (3.50 claims per 100 PCYs), general surgeons (4.70 claims per 100 PCYs), and obstetricians‐gynecologists (5.56 claims per 100 PCYs) (P |
| doi_str_mv | 10.1002/jhm.2244 |
| format | Article |
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An increasingly large proportion of inpatient care is provided by hospitalists. The care discontinuities inherent to hospital medicine raise concerns about malpractice risk. However, little published data exist on the medical liability risks associated with care by hospitalists.
OBJECTIVE
We sought to determine the risks and outcomes of malpractice claims against hospitalists in internal medicine.
DESIGN
Retrospective observational analysis.
MEASUREMENTS
Using claims data from a liability insurer‐maintained database of over 52,000 malpractice claims, we measured the rates of malpractice claims against hospitalists compared to other physician specialties, types of allegations against hospitalists, contributing factors, and the severity of injury in and outcomes of these claims.
RESULTS
Hospitalists had a malpractice claims rate of 0.52 claims per 100 physician coverage years (PCYs), which was significantly lower than that of nonhospitalist internal medicine physicians (1.91 claims per 100 PCYs), emergency medicine physicians (3.50 claims per 100 PCYs), general surgeons (4.70 claims per 100 PCYs), and obstetricians‐gynecologists (5.56 claims per 100 PCYs) (P < 0.001 for all comparisons). The most common allegation types made against hospitalists were for errors in medical treatment (41.5%) and diagnosis (36.0%). The most common contributing factors underlying claims were deficiencies in clinical judgment (54.4%) and communication (36.4%). Of the claims made against hospitalists, 50.4% involved the death of the patient.
CONCLUSIONS
Despite fears of increased liability from the hospitalist model of care, hospitalists in internal medicine are subject to medical malpractice claims less frequently when compared to other internal medicine physicians and specialties. Journal of Hospital Medicine 2014;9:750–755. © 2014 Society of Hospital Medicine</description><identifier>ISSN: 1553-5592</identifier><identifier>EISSN: 1553-5606</identifier><identifier>DOI: 10.1002/jhm.2244</identifier><identifier>PMID: 25331989</identifier><language>eng</language><publisher>United States: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Databases, Factual - trends ; Female ; Hospitalists ; Humans ; Internal Medicine - economics ; Internal Medicine - legislation & jurisprudence ; Internal Medicine - trends ; Male ; Malpractice - economics ; Malpractice - legislation & jurisprudence ; Malpractice - trends ; Middle Aged ; Retrospective Studies</subject><ispartof>Journal of hospital medicine, 2014-12, Vol.9 (12), p.750-755</ispartof><rights>2014 Society of Hospital Medicine</rights><rights>2014 Society of Hospital Medicine.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3874-692869dae926c46db0919ce8e8cc1af1276485e3fbc744960985431ba17a37483</citedby><cites>FETCH-LOGICAL-c3874-692869dae926c46db0919ce8e8cc1af1276485e3fbc744960985431ba17a37483</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fjhm.2244$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fjhm.2244$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25331989$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schaffer, Adam C.</creatorcontrib><creatorcontrib>Puopolo, Ann Louise</creatorcontrib><creatorcontrib>Raman, Supriya</creatorcontrib><creatorcontrib>Kachalia, Allen</creatorcontrib><title>Liability impact of the hospitalist model of care</title><title>Journal of hospital medicine</title><addtitle>J. Hosp. Med</addtitle><description>BACKGROUND
An increasingly large proportion of inpatient care is provided by hospitalists. The care discontinuities inherent to hospital medicine raise concerns about malpractice risk. However, little published data exist on the medical liability risks associated with care by hospitalists.
OBJECTIVE
We sought to determine the risks and outcomes of malpractice claims against hospitalists in internal medicine.
DESIGN
Retrospective observational analysis.
MEASUREMENTS
Using claims data from a liability insurer‐maintained database of over 52,000 malpractice claims, we measured the rates of malpractice claims against hospitalists compared to other physician specialties, types of allegations against hospitalists, contributing factors, and the severity of injury in and outcomes of these claims.
RESULTS
Hospitalists had a malpractice claims rate of 0.52 claims per 100 physician coverage years (PCYs), which was significantly lower than that of nonhospitalist internal medicine physicians (1.91 claims per 100 PCYs), emergency medicine physicians (3.50 claims per 100 PCYs), general surgeons (4.70 claims per 100 PCYs), and obstetricians‐gynecologists (5.56 claims per 100 PCYs) (P < 0.001 for all comparisons). The most common allegation types made against hospitalists were for errors in medical treatment (41.5%) and diagnosis (36.0%). The most common contributing factors underlying claims were deficiencies in clinical judgment (54.4%) and communication (36.4%). Of the claims made against hospitalists, 50.4% involved the death of the patient.
CONCLUSIONS
Despite fears of increased liability from the hospitalist model of care, hospitalists in internal medicine are subject to medical malpractice claims less frequently when compared to other internal medicine physicians and specialties. Journal of Hospital Medicine 2014;9:750–755. © 2014 Society of Hospital Medicine</description><subject>Adult</subject><subject>Aged</subject><subject>Databases, Factual - trends</subject><subject>Female</subject><subject>Hospitalists</subject><subject>Humans</subject><subject>Internal Medicine - economics</subject><subject>Internal Medicine - legislation & jurisprudence</subject><subject>Internal Medicine - trends</subject><subject>Male</subject><subject>Malpractice - economics</subject><subject>Malpractice - legislation & jurisprudence</subject><subject>Malpractice - trends</subject><subject>Middle Aged</subject><subject>Retrospective Studies</subject><issn>1553-5592</issn><issn>1553-5606</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kF1LwzAUQIMobk7BXyAFX3zpzHeaRx1uc8wpfuBjSLOUZbZrbVp0_96OdRMEn-6FezhcDgDnCPYRhPh6ucj6GFN6ALqIMRIyDvnhbmcSd8CJ90sIKYkYPQYdzAhBMpJdgKZOxy511TpwWaFNFeRJUC1ssMh94SqdOl8FWT636eZgdGlPwVGiU2_P2tkDb8O718E4nD6O7gc309CQSNCQSxxxOddWYm4on8dQImlsZCNjkE4QFpxGzJIkNoJSyaFsXiMo1khoImhEeuBq6y3K_LO2vlKZ88amqV7ZvPYKcUKxgBTzBr38gy7zulw13zUUlgxDQcmv0JS596VNVFG6TJdrhaDaZFRNRrXJ2KAXrbCOMzvfg7tuDRBugS-X2vW_IjUZP7TClm9y2u89r8sPxQURTL3PRuqFjGa3k6dnNSQ_ahKHgg</recordid><startdate>201412</startdate><enddate>201412</enddate><creator>Schaffer, Adam C.</creator><creator>Puopolo, Ann Louise</creator><creator>Raman, Supriya</creator><creator>Kachalia, Allen</creator><general>Blackwell Publishing Ltd</general><general>Frontline Medical Communications</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope></search><sort><creationdate>201412</creationdate><title>Liability impact of the hospitalist model of care</title><author>Schaffer, Adam C. ; Puopolo, Ann Louise ; Raman, Supriya ; Kachalia, Allen</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3874-692869dae926c46db0919ce8e8cc1af1276485e3fbc744960985431ba17a37483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Databases, Factual - trends</topic><topic>Female</topic><topic>Hospitalists</topic><topic>Humans</topic><topic>Internal Medicine - economics</topic><topic>Internal Medicine - legislation & jurisprudence</topic><topic>Internal Medicine - trends</topic><topic>Male</topic><topic>Malpractice - economics</topic><topic>Malpractice - legislation & jurisprudence</topic><topic>Malpractice - trends</topic><topic>Middle Aged</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schaffer, Adam C.</creatorcontrib><creatorcontrib>Puopolo, Ann Louise</creatorcontrib><creatorcontrib>Raman, Supriya</creatorcontrib><creatorcontrib>Kachalia, Allen</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hospital medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schaffer, Adam C.</au><au>Puopolo, Ann Louise</au><au>Raman, Supriya</au><au>Kachalia, Allen</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Liability impact of the hospitalist model of care</atitle><jtitle>Journal of hospital medicine</jtitle><addtitle>J. Hosp. Med</addtitle><date>2014-12</date><risdate>2014</risdate><volume>9</volume><issue>12</issue><spage>750</spage><epage>755</epage><pages>750-755</pages><issn>1553-5592</issn><eissn>1553-5606</eissn><abstract>BACKGROUND
An increasingly large proportion of inpatient care is provided by hospitalists. The care discontinuities inherent to hospital medicine raise concerns about malpractice risk. However, little published data exist on the medical liability risks associated with care by hospitalists.
OBJECTIVE
We sought to determine the risks and outcomes of malpractice claims against hospitalists in internal medicine.
DESIGN
Retrospective observational analysis.
MEASUREMENTS
Using claims data from a liability insurer‐maintained database of over 52,000 malpractice claims, we measured the rates of malpractice claims against hospitalists compared to other physician specialties, types of allegations against hospitalists, contributing factors, and the severity of injury in and outcomes of these claims.
RESULTS
Hospitalists had a malpractice claims rate of 0.52 claims per 100 physician coverage years (PCYs), which was significantly lower than that of nonhospitalist internal medicine physicians (1.91 claims per 100 PCYs), emergency medicine physicians (3.50 claims per 100 PCYs), general surgeons (4.70 claims per 100 PCYs), and obstetricians‐gynecologists (5.56 claims per 100 PCYs) (P < 0.001 for all comparisons). The most common allegation types made against hospitalists were for errors in medical treatment (41.5%) and diagnosis (36.0%). The most common contributing factors underlying claims were deficiencies in clinical judgment (54.4%) and communication (36.4%). Of the claims made against hospitalists, 50.4% involved the death of the patient.
CONCLUSIONS
Despite fears of increased liability from the hospitalist model of care, hospitalists in internal medicine are subject to medical malpractice claims less frequently when compared to other internal medicine physicians and specialties. Journal of Hospital Medicine 2014;9:750–755. © 2014 Society of Hospital Medicine</abstract><cop>United States</cop><pub>Blackwell Publishing Ltd</pub><pmid>25331989</pmid><doi>10.1002/jhm.2244</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of hospital medicine, 2014-12, Vol.9 (12), p.750-755 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Aged Databases, Factual - trends Female Hospitalists Humans Internal Medicine - economics Internal Medicine - legislation & jurisprudence Internal Medicine - trends Male Malpractice - economics Malpractice - legislation & jurisprudence Malpractice - trends Middle Aged Retrospective Studies |
| title | Liability impact of the hospitalist model of care |
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