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{"title":"Assessment of Claimant, Clinical, and Financial Characteristics of Teleradiology Medical Malpractice Cases.","authors":"Adam C Schaffer, Tarek Zawi, Jonathan S Einbinder, Luke Sato, Aaron D Sodickson","doi":"10.1148/radiol.232806","DOIUrl":null,"url":null,"abstract":"<p><p>Background The increasing use of teleradiology has been accompanied by concerns relating to risk management and patient safety. Purpose To compare characteristics of teleradiology and nonteleradiology radiology malpractice cases and identify contributing factors underlying these cases. Materials and Methods In this retrospective analysis, a national database of medical malpractice cases was queried to identify cases involving telemedicine that closed between January 2010 and March 2022. Teleradiology malpractice cases were identified based on manual review of cases in which telemedicine was coded as one of the contributing factors. These cases were compared with nonteleradiology cases that closed during the same time period in which radiology had been determined to be the primary responsible clinical service. Claimant, clinical, and financial characteristics of the cases were recorded, and continuous or categorical data were compared using the Wilcoxon rank-sum test or Fisher exact test, respectively. Results This study included 135 teleradiology and 3474 radiology malpractices cases. The death of a patient occurred more frequently in teleradiology cases (48 of 135 [35.6%]) than in radiology cases (685 of 3474 [19.7%]; <i>P</i> < .001). Cerebrovascular disease was a more common final diagnosis in the teleradiology cases (13 of 135 [9.6%]) compared with the radiology cases (124 of 3474 [3.6%]; <i>P</i> = .002). Problems with communication among providers was a more frequent contributing factor in the teleradiology cases (35 of 135 [25.9%]) than in the radiology cases (439 of 3474 [12.6%]; <i>P</i> < .001). Teleradiology cases were more likely to close with indemnity payment (79 of 135 [58.5%]) than the radiology cases (1416 of 3474 [40.8%]; <i>P</i> < .001) and had a higher median indemnity payment than the radiology cases ($339 230 [IQR, $120 790-$731 615] vs $214 063 [IQR, $66 620-$585 424]; <i>P</i> = .01). Conclusion Compared with radiology cases, teleradiology cases had higher clinical and financial severity and were more likely to involve issues with communication. © RSNA, 2024 See also the editorial by Mezrich in this issue.</p>","PeriodicalId":20896,"journal":{"name":"Radiology","volume":"311 1","pages":"e232806"},"PeriodicalIF":12.1000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1148/radiol.232806","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
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Abstract
Background The increasing use of teleradiology has been accompanied by concerns relating to risk management and patient safety. Purpose To compare characteristics of teleradiology and nonteleradiology radiology malpractice cases and identify contributing factors underlying these cases. Materials and Methods In this retrospective analysis, a national database of medical malpractice cases was queried to identify cases involving telemedicine that closed between January 2010 and March 2022. Teleradiology malpractice cases were identified based on manual review of cases in which telemedicine was coded as one of the contributing factors. These cases were compared with nonteleradiology cases that closed during the same time period in which radiology had been determined to be the primary responsible clinical service. Claimant, clinical, and financial characteristics of the cases were recorded, and continuous or categorical data were compared using the Wilcoxon rank-sum test or Fisher exact test, respectively. Results This study included 135 teleradiology and 3474 radiology malpractices cases. The death of a patient occurred more frequently in teleradiology cases (48 of 135 [35.6%]) than in radiology cases (685 of 3474 [19.7%]; P < .001). Cerebrovascular disease was a more common final diagnosis in the teleradiology cases (13 of 135 [9.6%]) compared with the radiology cases (124 of 3474 [3.6%]; P = .002). Problems with communication among providers was a more frequent contributing factor in the teleradiology cases (35 of 135 [25.9%]) than in the radiology cases (439 of 3474 [12.6%]; P < .001). Teleradiology cases were more likely to close with indemnity payment (79 of 135 [58.5%]) than the radiology cases (1416 of 3474 [40.8%]; P < .001) and had a higher median indemnity payment than the radiology cases ($339 230 [IQR, $120 790-$731 615] vs $214 063 [IQR, $66 620-$585 424]; P = .01). Conclusion Compared with radiology cases, teleradiology cases had higher clinical and financial severity and were more likely to involve issues with communication. © RSNA, 2024 See also the editorial by Mezrich in this issue.
评估远程放射学医疗事故案件的索赔人、临床和财务特征。
背景 远程放射学的应用日益广泛,同时也引起了人们对风险管理和患者安全的关注。目的 比较远程放射学和非远程放射学放射学渎职案件的特点,并确定这些案件的诱因。材料与方法 在这项回顾性分析中,我们查询了全国医疗事故案例数据库,以确定 2010 年 1 月至 2022 年 3 月间结案的涉及远程医疗的案例。远程放射学医疗事故病例是在人工审核的基础上确定的,其中远程医疗被编码为促成因素之一。我们将这些案例与同期结案的非远程放射学案例进行了比较,在这些案例中,放射学被确定为主要负责的临床服务。病例的索赔人、临床和财务特征均被记录在案,连续或分类数据分别采用 Wilcoxon 秩和检验或 Fisher 精确检验进行比较。结果 本研究包括 135 个远程放射学案例和 3474 个放射学渎职案例。远程放射学病例(135 例中的 48 例[35.6%])比放射学病例(3474 例中的 685 例[19.7%];P < .001)中患者死亡的发生率更高。与放射科病例(3474 例中的 124 例 [3.6%];P = .002)相比,脑血管疾病在远程放射科病例(135 例中的 13 例 [9.6%])中是更常见的最终诊断。与放射科病例(3474 例中的 439 例 [12.6%];P < .001)相比,远程放射科病例(135 例中的 35 例 [25.9%])更常见的诱因是医疗服务提供者之间的沟通问题。远程放射学病例(135 例中的 79 例 [58.5%])比放射学病例(3474 例中的 1416 例 [40.8%];P < .001)更有可能以赔偿金结案,赔偿金中位数也比放射学病例高(339 230 美元 [IQR, 120 790-731 615 美元] vs 214 063 美元 [IQR, 66 620-585 424 美元];P = .01)。结论 与放射科病例相比,远程放射科病例的临床和财务严重程度更高,更有可能涉及沟通问题。©RSNA,2024 参见本期Mezrich的社论。
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