Journals Proceedings

Abstract

Introduction: Defensive Medicine (DM) affects healthcare systems worldwide. The concerns and perception about medical liability could lead practitioners to practise defensive medicine. The role of other possible determinants remains mostly unclear. Objective: to assess the prevalence of the practice of DM among Italian hospital physicians, its costs, and its determinants. Methods: Cross-sectional web survey was conducted. Main Outcome Measures: number of physicians reporting to have engaged in any DM behaviour in the last year. Results: 1,313 physicians completed the survey. 685 physicians stated that they practise DM. Almost all the respondents believed that DM would increase in the near future. 46.5% of the interviewed expected to adopt more DM within the next year. Most of the interviewed physicians believed that practising DM would reduce their risk of being sued for malpractice; they also believed DM is not harmful to their patients. DM absorbed 10.71% of the total national health expenditure of Italy, with an estimated total cost of about €11.60 billion per year. Malpractice reform, together with a systematic use of evidence-based clinical guidelines, has been indicated to be the most effective solution for reducing DM. Conclusions: DM is a significant factor in healthcare costs without adding any benefit to patients. The economic burden of DM on healthcare systems should provide a substantial stimulus for a prompt review of this situation in a time of economic crisis.