Résumé :
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[BDSP. Notice produite par INIST-CNRS HR0xq8qd. Diffusion soumise à autorisation]. Context A small number of physicians experience a disproportionate share of malpractice claims and expenses. If malpractice risk is related in large measure to factors such as patient dissatisfaction with interpersonal behaviors, care and treatment, and access, it might be possible to monitor physicians'risk of being sued. Objective To examine the association between physicians'patient complaint records and their risk management experiences. Design, Setting, and Participants Retrospective longitudinal cohort study of 645 general and specialist physicians in a large US medical group between January 1992 and March 1998, accounting for 2546 physician-years of care. Main Outcome Measures Computerized records of all unsolicited patient complaints were recorded by the medical center's patient affairs office, coded to characterize the nature of the problem and alleged offender, and compared with each physicians risk management records for the same period. Results Both patient complaints and risk management events were higher for surgeons than nonsurgeons. Specifically, 137 (32%) of the 426 nonsurgeons had at least 1 risk management file compared with nearly two thirds (137 [63% ] of 219) of all surgeons (X21=54.7, P<. both complaint and risk management data were positively correlated with physicians of clinical activity. logistic regression revealed that file openings expenditures law-suits significantly related to total numbers patient complaints even when adjusted for predictive concordance specialty group count activity sex was lawsuits multiple>
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