Abstract
Background
Defensive medicine has recently escalated as a problem of
progressively increasing magnitude and concern. The practice
of defensive medicine is mainly associated to the rising number
of medical malpractice lawsuits. This study was aimed to
perform a literature review to analyze the economic burden of
defensive medicine in Italy and to identify which solutions,
adopted in Europe, have proven effective in reducing the
phenomenon.
Methods
A literature review was performed, during the period
November 2014-April 2015, by consulting the main electronic
databases, institutional websites and grey literature. Specific
key words and MeSH terms were used.
Results
In Italy defensive medicine costs 10 billion/year (10.5% of
GDP) and it represents the first category of healthcare
wastes (26% of the total). In Europe the number of
litigations for medical malpractice has increased significantly
over the last decade; this increase ranges from more
50% in Britain, Scandinavia, the Baltic countries and
Eastern Europe, to more 200–500% in Germany, Italy, the
Iberian and Mediterranean Area countries. In countries
where a no-fault system or a system of conflict mediation is
in force, most of the litigations are disputed out of the court
of law: the claims resolved in court are 0.1% in Sweden,
0.3% in Finland, 0.5% in Denmark and 4% in Britain
compared to 100% of cases resolved through judicial in
Portugal and the Netherlands, 98% in Malta, 86% in Italy
and 60% in France.
Conclusions
Defensive medicine is consequence of several factors, particularly
the increased risks in healthcare, the impact of social and
cultural changes and some facilitating aspects of the legal
system. Various solutions have been adopted internationally
with the aim of reducing defensive medical acts. The use of
mediation to favour dispute settlements out of the court of law
and the adoption of no-fault systems have turned out to be the
most effective approaches.
Key messages
The medicine defensive acts are widespread among physician
and determine an increase of healthcare costs and a
reduction of healthcare quality
The adoption of no-fault systems and extra- judicial
mediation are shown to be the most effective strategies to
reduce the number of litigation in courts of law, with
consequent economic savings.
| Lingua originale | English |
|---|---|
| pagine (da-a) | 145-145 |
| Numero di pagine | 1 |
| Rivista | European Journal of Public Health |
| Volume | 25 (Suppl. 3) |
| Stato di pubblicazione | Pubblicato - 2015 |
| Evento | 8th European Public Health Conference “Health in Europe – from global to local policies, methods and practices”. - Milano Durata: 14 ott 2015 → 17 ott 2015 |
Keywords
- Defensive Medicine
- Healthcare costs