Can practice guidelines reduce the number and costs of malpractice claims?

Article Abstract:

Practice guidelines for physicians may improve the quality of health care and reduce the number and cost of malpractice claims. Physicians spend an estimated seven billion dollars per year on malpractice insurance and order extra tests and procedures to protect themselves from malpractice lawsuits. Practice guidelines would be developed by a group of national experts and provide a set of standards used to settle malpractice cases. In 1992, Maine will begin using a set of approved guidelines in anesthesiology, emergency medicine and obstetrics and gynecology. These guidelines should fulfill several criteria to be useful. They should discuss conditions or procedures often involved in malpractice lawsuits and be easily interpreted in a legal setting. They should be widely accepted by the medical community and improve the quality of health care. They should be flexible and adaptable to different medical situations.

Medicine, Medical personnel, Malpractice, Medical malpractice, Medical practice

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Variation in office-based quality: a claims-based profile of care provided to Medicare patients with diabetes

Article Abstract:

Primary care physicians may not provide optimal office-based medical care to many elderly patients with diabetes. Researchers studied Medicare claims data to evaluate the office-based care provided to 97,388 diabetic patients in Maryland, Alabama, and Iowa. Between July 1990 and June 1991, only 16.3% of the patients received a hemoglobin A1C test, 45.9% had an ophthalmologic examination, and 55.1% received a total cholesterol test. National practice guidelines and physician panels recommend that diabetic patients have these tests at least once per year. The use of these tests and procedures differed significantly by state and most were performed less frequently in rural areas compared to urban locations. Primary care providers' specialty did not greatly affect the use of most tests or procedures.

Care and treatment, Elderly, Evaluation, Diabetes mellitus, Physicians (General practice), General practitioners, Ambulatory medical care, Ambulatory care, Diabetes in old age

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Hospital Peer Review and Clinical Privileges Actions To Report or Not Report

Article Abstract:

Keeping all reports anonymous may encourage more hospitals to report disciplinary actions against doctors. The Health Care Quality Improvement Act of 1986 created the National Practitioner Data Bank (NPDB). The NPDB acts as a depository of all disciplinary actions taken against a doctor. These include malpractice suits, suspension of privileges and other disciplinary actions. A 1999 study found that the number of disciplinary actions reported by hospitals was low and varied substantially from one region to another. Many hospitals may not report such actions because they could expose themselves to potential litigation.

Editorial, Discipline, Physicians, Medical professions, Information services, Peer review

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