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Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians

Background and Objectives: This study aims to contribute to the definition of the defensive medicine phenomenon between obstetricians and gynecologists, as well as to possible effects on the frequency of deliveries performed by cesarean sections (CS). Materials and Methods: a digital questionnaire w...

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Autores principales: Fineschi, Vittorio, Arcangeli, Mauro, Di Fazio, Nicola, Del Fante, Zoe, Fineschi, Benedetta, Santoro, Paola, Frati, Paola
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8472348/
https://www.ncbi.nlm.nih.gov/pubmed/34574870
http://dx.doi.org/10.3390/healthcare9091097
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author Fineschi, Vittorio
Arcangeli, Mauro
Di Fazio, Nicola
Del Fante, Zoe
Fineschi, Benedetta
Santoro, Paola
Frati, Paola
author_facet Fineschi, Vittorio
Arcangeli, Mauro
Di Fazio, Nicola
Del Fante, Zoe
Fineschi, Benedetta
Santoro, Paola
Frati, Paola
author_sort Fineschi, Vittorio
collection PubMed
description Background and Objectives: This study aims to contribute to the definition of the defensive medicine phenomenon between obstetricians and gynecologists, as well as to possible effects on the frequency of deliveries performed by cesarean sections (CS). Materials and Methods: a digital questionnaire was administered through a mail-list including 600 gynecological specialists (of these 168 doctors completed the test), both in public and private settings. It was made of twenty multiple choice questions, concerning their awareness about the practice of defensive medicine and the planning and execution of CS. All doctors involved received clear and complete information about the purpose of this study and about the organizations that received their answers. Analyses of variance and regression were performed to describe differences between groups and to estimate the relationships between variables. The value of p < 0.5 was considered statistically relevant. Results: our analysis revealed that most respondents are confident with the defensive medicine definition and characteristics. This survey confirmed that gynecologists fear legal actions promoted by their patients and therefore modulate their choices by implementing professional behaviors of so-called “defensive medicine”. This relates to a greater number of medical liability judgements, which more often concern omission or delayed execution of cesarean section, rather than unskillful surgical procedures. Conclusions: there are few data to support a relation between the high rate of CS and defensive medicine. Numerous scientific studies associated this CS rate with the phenomenon of defensive medicine. This practice is constantly growing in all medical areas, especially in high-risk specialties such as obstetrics and gynecology. Our study highlights physicians’ awareness of adopting defensive medicine behaviors in their clinical practice, affecting the choice of the type of delivery to be performed.
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spelling pubmed-84723482021-09-28 Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians Fineschi, Vittorio Arcangeli, Mauro Di Fazio, Nicola Del Fante, Zoe Fineschi, Benedetta Santoro, Paola Frati, Paola Healthcare (Basel) Article Background and Objectives: This study aims to contribute to the definition of the defensive medicine phenomenon between obstetricians and gynecologists, as well as to possible effects on the frequency of deliveries performed by cesarean sections (CS). Materials and Methods: a digital questionnaire was administered through a mail-list including 600 gynecological specialists (of these 168 doctors completed the test), both in public and private settings. It was made of twenty multiple choice questions, concerning their awareness about the practice of defensive medicine and the planning and execution of CS. All doctors involved received clear and complete information about the purpose of this study and about the organizations that received their answers. Analyses of variance and regression were performed to describe differences between groups and to estimate the relationships between variables. The value of p < 0.5 was considered statistically relevant. Results: our analysis revealed that most respondents are confident with the defensive medicine definition and characteristics. This survey confirmed that gynecologists fear legal actions promoted by their patients and therefore modulate their choices by implementing professional behaviors of so-called “defensive medicine”. This relates to a greater number of medical liability judgements, which more often concern omission or delayed execution of cesarean section, rather than unskillful surgical procedures. Conclusions: there are few data to support a relation between the high rate of CS and defensive medicine. Numerous scientific studies associated this CS rate with the phenomenon of defensive medicine. This practice is constantly growing in all medical areas, especially in high-risk specialties such as obstetrics and gynecology. Our study highlights physicians’ awareness of adopting defensive medicine behaviors in their clinical practice, affecting the choice of the type of delivery to be performed. MDPI 2021-08-25 /pmc/articles/PMC8472348/ /pubmed/34574870 http://dx.doi.org/10.3390/healthcare9091097 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fineschi, Vittorio
Arcangeli, Mauro
Di Fazio, Nicola
Del Fante, Zoe
Fineschi, Benedetta
Santoro, Paola
Frati, Paola
Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians
title Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians
title_full Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians
title_fullStr Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians
title_full_unstemmed Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians
title_short Defensive Medicine in the Management of Cesarean Delivery: A Survey among Italian Physicians
title_sort defensive medicine in the management of cesarean delivery: a survey among italian physicians
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8472348/
https://www.ncbi.nlm.nih.gov/pubmed/34574870
http://dx.doi.org/10.3390/healthcare9091097
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