1994年6月

醫療糾紛風險與防禦性醫療行為
The Risk of Medical Malpractice Claim and the Defensive Practice of Medicine

研究論文 Research Article

謝啟瑞
Chee-ruey Hsieh

199-230

本文利用Probit模型，實證估計影響醫師防禦性醫療行爲傾向的因素。實證資料係來自對臺灣地區西醫師所進行的問卷調査結果，共有1,131個樣本。迴歸分析的結果發現，曾經有過醫療糾紛經驗的醫師，較傾向於採行防禦性的醫療行爲，而且愈是最近發生的醫療糾紛，此種傾向愈大。除此之外，醫師執業科別的差異，亦對防禦性醫療行爲傾向，具有顯著的解釋能力。這方面的主要發現，有下列兩項： 1．精神科、麻醉科、復健科、放射線科與病理科等科別的醫師，較少採取防禦性的醫療行爲； 2．外科與婦產科的醫師，較常採取增加檢驗或治療的防禦性醫療行爲。上述研究結果證實，醫療糾紛風險確實會改變醫師的執業行爲。

This paper presents a probit model to estimate the determinants of physician's propensity of practicing defensive medicine in Taiwan. The empirical data were drawn from a national physician survey conducted in November 1991. The survey data included 1,131 physicians and  had a 18% response rate. The empirical results indicate that physicians who have experiences of medical malpractice claims are more likely to prac­tice defensive medicine. The more recent is the experience of claims, the higher is the propensity of practicing defensive medicine. Also, the re­sults show that surgeons, obstetricians and gynecologists are more likely to prescribe more tests and treatment procedures. Overall, the empiri­cal evidence suggests that the risk of medical liability actually forces the physicians to change their practice behaviors.

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