Akademik Veri Yönetim Sistemi
INTERNATIONAL JOURNAL OF ADVANCED BIOTECHNOLOGY AND RESEARCH, cilt.8, sa.4, ss.1510-1518, 2017 (ESCI)
Background: Defensive medicine (DM) is explained as ordering more and more tests, or applying various procedures, visits to reduce exposure to medical negligence or malpractice liability. Objective: We performed observed the extent and characteristics of Defensive medicine (DM) among Iranian high-risk specialist physicians who are working in oil and refineries health affairs department. Methods: This is a retrospective, cross-sectional, postal questionnaire survey. A random sample of 30 physicians (aged 25-65 years) from four major medical disciplines including obstetrics/gynecology, orthopedic surgery, general surgery and ophthalmology was drown from the Naft grand hospital and oil and refineries health affairs department databases, southwestern region, Iran from 2011 to 2017. Answers to questions on negative DM practices, understanding of certain aspects of the terms of clinical governance and hospital accreditation systems were the main outcomes. Results: DM was more prevalent among orthopedic surgeons (30%) and obstetrics and gynecologists (29%). Trends of medical activities showed increasing and decreasing pattern in 2011-2014 and 2014-2017, respectively. The obstetrics and gynecology specialists were more likely increase referral rate (OR: 2.0, 95% CI: 0.457 - 8.74) and follow-up (OR: 2.0, 95% CI: 0.34 - 11.75) in 2011-2014 compared with other high-risk physicians. Hence, general surgeons (OR: 2.5, 95% CI: 0.44 - 13.9) and ophthalmologists (OR: 2.0, 95% CI: 0.34 - 11.75) were more likely increase diagnostic testing. DM is not very prevalent in Iran. Conclusion: The results showed that DM is more prevalent among orthopedic surgeons and obstetrics and gynecologists. Although DM may lead to better quality care, it is performing more unnecessary tests, consultants and hospitalization. This study showed that implementing clinical governance and hospital accreditation may lead to shift from negative to positive DM performance, which is beneficial for organization, medical professionals and patients.