英语翻译Our study has four main limitations.First,the sample was drawn from insurers and involved clinical categories that are not representative of malpractice claims nationwide.Academic institutions and the physicians who staff them were overre

英语翻译Our study has four main limitations.First,the sample was drawn from insurers and involved clinical categories that are not representative of malpractice claims nationwide.Academic institutions and the physicians who staff them were overre
英语翻译
Our study has four main limitations.First,the sample was drawn from insurers and involved clinical categories that are not representative of malpractice claims nationwide.Academic institutions and the physicians who staff them were overrepresented,as were claims that fell within our clinical categories of interest.Although it is difficult to make comparisons with other samples of closed claims,both the proportion of claims receiving payments and the average amount of the payments appear to be high according to national standards,which probably reflects the preponderance of severe injuries in our sample.
Second,the reliability of judgments that error had occurred was moderate overall; agreement was especially difficult to obtain among claims involving missed or delayed diagnoses.Third,whether claims had merit was determined by reference to error,which is not identical to the legal concept of negligence,although the two cleave so closely that experts in both medicine and law have trouble explaining the difference.Fourth,reviewers' awareness of the litigation outcome may have biased them toward finding errors in claims that resulted in compensation,and vice versa.35,36 To the extent that such hindsight bias was a factor,its likely effect would be to pull the rate of non-error claims (37 percent) toward the payment rate (56 percent),resulting in an overestimate of the prevalence and costs of claims not associated with error.
Frivolous litigation is in the bull's-eye of the current tort-reform efforts of state and federal legislators.The need to constrain the number and costs of frivolous lawsuits is touted as one of the primary justifications for such popular reforms as limits on attorneys' fees,caps on damages,panels for screening claims,and expert precertification requirements.Our findings suggest that moves to curb frivolous litigation,if successful,will have a relatively limited effect on the caseload and costs of litigation.The vast majority of resources go toward resolving and paying claims that involve errors.A higher-value target for reform than discouraging claims that do not belong in the system would be streamlining the processing of claims that do belong.
Supported by grants from the Agency for Healthcare Research and Quality (HS011886-03 and KO2HS11285,to Dr.Studdert),and the Harvard Risk Management Foundation.No potential conflict of interest relevant to this article was reported.
We are indebted to Allison Nagy for her assistance in compiling the data set; to Karen Lifford,Tom McElrath,and Martin November for their assistance with the obstetric component of the study; to Selwyn Rogers for his assistance with the surgical component; to Eric Thomas and Eric Poon for their assistance with the medication and diagnostic components; and to John Ayanian,Arnold Epstein,John Orav,and Charles Silver for their valuable comments on an earlier draft of the manuscript.

英语翻译Our study has four main limitations.First,the sample was drawn from insurers and involved clinical categories that are not representative of malpractice claims nationwide.Academic institutions and the physicians who staff them were overre
我们的研究有四个主要的局限性.首先,样品所属的保险公司、并不代表声称对渎职行为的临床科.学术机构和他们的医生雇员,坚持要求临床科的索赔.虽然与其他样品的不公开索赔很难做比较,索赔能收到的总额的比例和平均总额出现按照国家的高标准,这或许反映了我们的样品伤势严重.
第二,判断的可靠性发生的错误已整体减弱,尤其难以使涉及出错和延迟判断中作出的索赔选择得到一致.
第三,参考误差决定索赔是否存在价值,并不是完全相同的对于过失的法律概念,而双方的法学和医学专家的解释都存在差异.
第四,陪审员意识到诉讼的结果可能有偏见的倒向发现错误理赔金的一方来赔偿.反之亦然.达到35,36的程度导致这样的吹“偏哨”成为抽象因素,可能会将（37%）的无误差索赔提升到（56%）的索赔比例.可以大胆的估算,最终的费用大多将与误差无关.
轻浮的诉讼将成为地方和联邦政府立法委员改革侵权行为的关键.需要的数量和成本是约束打官司普遍限制律师费用的主要原因.阻止损害、筛选索赔的委员会、和专家precertification要求.我们的研究结果控制了轻浮的诉讼,如果成功,将会在官司和诉讼费上起到相对有效地作用.

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