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Enregistrement W56309649

The impact of the medical malpractice crisis on OB-GYNs and patients in southern New Jersey.

2003· article· en· W56309649 sur OpenAlexaboutno aff
Judy Donlen, Janet S Puro

Notice bibliographique

RevuePubMed · 2003
Typearticle
Langueen
DomaineEconomics, Econometrics and Finance
ThématiqueHealthcare Policy and Management
Établissements canadiensnon disponible
Organismes subventionnairesnon disponible
Mots-clésMalpracticeQuarter (Canadian coin)Defensive medicineMedical malpracticeMalpractice insuranceMedicineBusinessFamily medicineDemographic economicsPolitical scienceActuarial scienceEconomicsGeographyLaw
DOInon disponible

Résumé

récupéré en direct d'OpenAlex

The results of this study indicate that the current medical malpractice crisis has created significant insurance affordability and accessibility problems for OB-GYNs in southern New Jersey. Even more important is the result that shows this crisis as beginning to have a very real impact on patient access to care. The average cost for malpractice coverage per physician increased from $34,616.67 in 2000 to $78,818.18 in 2003. This represents a 128% increase in just four years. As dramatic as these premium increases appear, the fact that many physicians have had to reduce their coverage in order to afford any malpractice coverage at all has not yet been taken into account. The increase in premiums particularly affects solo practitioners, such as those practicing in the more rural areas of southern New Jersey, because they are unable to take advantage of the economies of scale that larger practices enjoy. It is also the case that premium increases are even higher for high-risk subspecialties, such as maternal and fetal medicine. Certified nurse midwives are just beginning to see significant increases in their premiums as well. Fourteen point three percent of practices got quotes from three carriers this year, and 12.2% of practices got more than three quotes. This may indicate that there are physicians who are unable to find affordable coverage. More than one quarter of OB-GYN practices (26.5%) reported that their current carrier dropped one or more of the physicians in their practice during the most recent renewal period. Close to half of the practices (49%) that responded to the survey indicated that they came across at least one carrier who refused to provide a quote for liability coverage, while 14% of the practices indicated that more than three carriers refused to provide a quote. This indicates a significant problem with access to coverage. The current malpractice crisis already has had an impact on the way in which physicians practice medicine. Most significant, thirteen practices in the region indicated that at least one of their physicians had stopped delivering babies, two additional practices indicated that they had ceased delivering or caring for high-risk babies, and six practices indicated that at least one of their physicians had ceased performing surgical procedures. There are even more strategies that physicians in southern New Jersey are considering for the near future. Clearly, physicians believe that patient access to care is already a problem in southern New Jersey. If premiums do not stabilize in the very near future, there is every indication that southern New Jersey will have a severe access to care issue for its obstetrical patient population. Unfortunately, a recent report on the nation's medical malpractice insurance crisis predicts at least two more years of continuing financial problems for medical malpractice insurers. Despite the fact that New Jersey's state legislators ended their session without enacting any new tort reform laws, physicians across the state continue to apply pressure for passage of a bill to help the current medical liability crisis. Physicians plan a new round of lobbying and demonstrations beginning October 7, 2003.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction machine sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.

score de la tête « metaresearch » (Codex)0,001
score de la tête « metaresearch » (Gemma)0,004
Version: metacan-v3-hybrid-931329e0061cStatut de validation: machine_predicted_unvalidated
Catégories candidatesaucune
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Observationnel · Signal consensuel: Observationnel
GenreSignal candidat: Empirique · Signal consensuel: Empirique
Score de désaccord entre enseignants0,222
Score d'incertitude au seuil0,442

Scores du classifieur distillé par catégorie (deux têtes)

CatégorieCodexGemma
Métarecherche0,0010,004
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0000,000
Bibliométrie0,0010,001
Études des sciences et des technologies0,0020,001
Communication savante0,0020,001
Science ouverte0,0010,002
Intégrité de la recherche0,0010,001
Charge utile insuffisante (le modèle a refusé de juger)0,0050,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,049
Tête enseignante GPT0,265
Écart entre enseignants0,216 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.
Devis d'étudeObservationnel
Domainenon disponible
GenreEmpirique

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations9
Publié2003
Routes d'admission1
Résumé présentoui

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