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Defensive medicine practices among gastroenterologists in Japan

查看全文 作　　者：Toru [1]Hiyama;Masaharu [1]Yoshihara;Shinji [2]Tanaka;Yuji [3]Urabe;Yoshihiko [3]Ikegami;Tatsuma [3]Fukuhara;Kazuaki [3]Chayama 高影响力作者 机构地区：[1]Health Service Center, Hiroshima University, Higashihiroshima, Japan;[2]Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan;[3]Department of Medicine and Molecular Science, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan高影响力机构 出　　处：《World Journal of Gastroenterology》索引2006年第12卷第47期,共5页高影响力期刊 摘　　要：AIM: To clarify the prevalence of defensive medicine and the specific defensive medicine practices among gastro-enterologists in Japan.METHODS: A survey of gastroenterologists in Hiroshi-ma, Japan, was conducted by mail in March 2006. The number of gastroenterologists reporting defensive medi-cine behaviors or changes in their scope of practice and the reported defensive medicine practices, i.e., assurance and avoidance behaviors, were examined.RESULTS: A total of 131 (77%) out of 171 gastroenter-ologists completed the survey. Three (2%) respondents were sued, and most respondents (96%) had liability insurance. Nearly all respondents (98%) reported prac-ticing defensive medicine. Avoidance behaviors, such as avoiding certain procedures or interventions and avoiding caring for high-risk patients, were very common (96%). Seventy-five percent of respondents reported often avoiding certain procedures or interventions. However, seasoned gastroenterologists (those in practice for more than 20 years) adopted avoidance behaviors significantly less often than those in practice for less than 10 years. Assurance behaviors, i.e., supplying additional services of marginal or no medical value, were also widespread (91%). Sixty-eight percent of respondents reported that they sometimes or often referred patients to other spe-cialists unnecessarily.CONCLUSION: Defensive medicine may be highly prev-alent among gastroenterologists throughout Japan, withpotentially serious implications regarding costs, access, and both technical and interpersonal quality of care. 关 键 词：日本 药物 生物医学 临床应用
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