Volume 20 Issue 2
Feb.  2022
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Article Navigation >  Chinese Journal of General Practice  > 2022  >  20(2): 332-335
WU Shu-lu, FAN Jun-hong, DENG Xi-ming. Characteristics and causes of excessive medical treatment in intensive care units[J]. Chinese Journal of General Practice, 2022, 20(2): 332-335. doi: 10.16766/j.cnki.issn.1674-4152.002345
Citation: WU Shu-lu, FAN Jun-hong, DENG Xi-ming. Characteristics and causes of excessive medical treatment in intensive care units[J]. Chinese Journal of General Practice, 2022, 20(2): 332-335. doi: 10.16766/j.cnki.issn.1674-4152.002345
shu

Characteristics and causes of excessive medical treatment in intensive care units

doi: 10.16766/j.cnki.issn.1674-4152.002345
  • 1.

    Graduate School of Bengbu Medical College, Bengbu, Anhui 233000, China

Funds:

 SK2018A0182

  • Received Date: 2021-12-18
    Available Online: 2022-03-04
    Abstract
  •   Objective  To study the phenomenon of excessive medical treatment in ICU, discuss the characteristics and manifestations of excessive medical treatment in ICU, analyze the causes of its occurrence, and make suggestions to avoid excessive medical treatment in ICU.  Methods  The inpatient medical records of patients admitted to the comprehensive ICU of a third-grade A hospital the First Affiliated Hospital of Bengbu Medical College, Bengbu from July 2019 to December 2019 were selected as the research objects. The medical records of patients were analyzed by three senior ICU experts using case analysis method, and the cases of patients judged as excessive medical treatment were analyzed at the same time.  Results  A total of 359 cases were included in this study, among which 32 cases were determined by 3 experts to have excessive medical treatment, including 19 cases of invalid medical treatment, 11 cases of defensive medical treatment and 2 cases of inappropriate application of high and new technology, with a total incidence of 8.9%. Its characteristics were as follows: invalid medical treatment, defensive medical treatment and inappropriate application of high and new technology were the main manifestations. In the process of excessive medical treatment, the doctor was the giver of medical treatment, but the role of the doctor was sometimes not subjective and intentional, just a passive implementor. The reasons were mainly related to doctors' risk aversion, medical information asymmetry and inappropriate requirements of patients' family members.  Conclusions  Excessive medical treatment exists in ICU, and its characteristics and causes are related to social factors and the special diagnosis and treatment in ICU. Its forming factors include economic, social and ethical factors, as well as the medical level of doctors and the understanding of diseases. In view of these characteristics and forming factors, countermeasures and suggestions include perfecting the construction of laws and regulations, improving the doctor-patient relationship, striving to build a harmonious social environment in which doctors are respected and valued, and strengthening the management of high and new technology, strictly implementing the access system of new and high technologies, and strengthening the supervision of the application of new and high technologies.

     

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    • References(16)
  • [1]
    STORDAL K, WYDER C, TROBISH A, et al. Overtesting and overtreatment-statement from the European Academy of Paediatrics (EAP)[J]. Eur J Pediatr, 2019, 178(12): 1923-1927. doi: 10.1007/s00431-019-03461-1
    [2]
    SOSHI M, MIZUTA T, TOKUDA Y. Overtesting in Japan[J]. J Gen Fam Med, 2018, 19(2): 42. doi: 10.1002/jgf2.167
    [3]
    TOBANO G, DYAR O J, BEOVIC B, et al. Defensive medicine among antibiotic stewards: The international ESCMID AntibioLegal Map survey[J]. J Antimicrob Chemother, 2018, 73(7): 1989-1996. doi: 10.1093/jac/dky098
    [4]
    高长安, 张锦英, 张洪江. 资本与道德: 从医疗双重标准透视过度医疗本质[J]. 医学与哲学, 2016, 37(3): 16-19. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201603006.htm
    [5]
    张洪松, 朱家明. 过度医疗的司法界定与伦理审视[J]. 医学与哲学, 2019, 40(20): 22-24, 52. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201920006.htm
    [6]
    刘雪娇, 王颢颖, 张凤, 等. 过度医疗的诱因分析及界定方法研究[J]. 中国卫生事业管理, 2016, 33(3): 177-180. https://www.cnki.com.cn/Article/CJFDTOTAL-ZWSG201603007.htm
    [7]
    LYU H, XU T, BROTMAN D, et al. Overtreatment in the United States[J]. PLoS One, 2017, 12(9): e0181970. doi: 10.1371/journal.pone.0181970
    [8]
    傅钰洁, 陈维进. 论无效医疗与无效医疗策略[J]. 中国医学伦理学, 2017, 30(3): 311-314. https://www.cnki.com.cn/Article/CJFDTOTAL-XNLX201703013.htm
    [9]
    ERIC D K. Defensive medicine: A case and review of its status and possible solutions[J]. Clin Pract Cases Emerg Med, 2019, 3(4): 329-332. doi: 10.5811/cpcem.2019.9.43975
    [10]
    GARATTINI L, PADULA A. Defensive medicine in Europe: A 'full circle'?[J]. Eur J Health Econ, 2020, 21(4): 477-482. doi: 10.1007/s10198-019-01151-1
    [11]
    RENKEMA E, AHAUS K, BROEKHUIS, et al. Triggers of defensive medical behaviours: A cross-sectional study among physicians in the Netherlands[J]. BMJ Open, 2019, 9(6): e025108. doi: 10.1136/bmjopen-2018-025108
    [12]
    RAPOSO V L. Defensive medicine and the imposition of a more demanding standard of care[J]. J Legal Med, 2019, 39(4): 401-416. doi: 10.1080/01947648.2019.1677273
    [13]
    徐莉. 论防御性医疗行为与过度医疗行为的关系[J]. 医学与社会, 2016, 29(2): 41-43. https://www.cnki.com.cn/Article/CJFDTOTAL-YXSH201602013.htm
    [14]
    屠国伟, 罗哲, 王春生, 等. 复旦大学附属中山医院心源性休克VA-ECMO治疗规范(v1.2019)[J]. 中国临床医学, 2019, 26(4): 667-672. https://www.cnki.com.cn/Article/CJFDTOTAL-LCYX201904033.htm
    [15]
    TRUDZINSKI F C, KAESTNER F, SCHAFERS H J, et al. Outcome of patients with interstitial lung disease treated with extracorporeal membrane oxygenation for acute respiratory failure[J]. Am J Respir Crit Care Med, 2016, 193(5): 527-533. doi: 10.1164/rccm.201508-1701OC
    [16]
    ZHU L L, DAI H P, WANG C. Current therapies for patients with acute exacerbation of idiopathic pulmonary fibrosis[J]. Chin Med J (Engl), 2020, 133(12): 1470-1472. https://pubmed.ncbi.nlm.nih.gov/32558705/
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