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[PMID]:29049120
[Au] Autor:Abrecht CR; Brovman EY; Greenberg P; Song E; Rathmell JP; Urman RD
[Ad] Endereço:From the *Department of Anesthesia and Perioperative Care, Division of Pain Medicine, University of California San Francisco, San Francisco, California; †Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ‡Controlled Risk Insurance Company (CRICO) Strategies, Boston, Massachusetts; and §Harvard Medical School, Boston, Massachusetts.
[Ti] Título:A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.
[So] Source:Anesth Analg;125(5):1761-1768, 2017 Nov.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO). The goal of this study was to identify patient medical comorbidities and aberrant drug behaviors, as well as prescriber practices associated with patient injury and malpractice claims. Another objective was to identify claims most likely to result in payments and use this information to propose a strategy for reducing medicolegal risk. METHODS: The CRICO Strategies Comparative Benchmarking System is a database of claims drawing from >350,000 malpractice claims from Harvard-affiliated institutions and >400 other academic and community institutions across the United States. This database was queried for closed claims from January 1, 2009, to December 31, 2013, and identified 37 cases concerning noninterventional, outpatient chronic pain management. Each file consisted of a narrative summary, including expert witness testimony, as well as coded fields for patient demographics, medical comorbidities, the alleged damaging event, the alleged injurious outcome, the total financial amount incurred, and more. We performed an analysis using these claim files. RESULTS: The mean patient age was 43.5 years, with men representing 59.5% of cases. Payments were made in 27% of cases, with a median payment of $72,500 and a range of $7500-$687,500. The majority of cases related to degenerative joint disease of the spine and failed back surgery syndrome; no patients in this series received treatment of malignant pain. Approximately half (49%) of cases involved a patient death. The use of long-acting opioids and medical conditions affecting the cardiac and pulmonary systems were more closely associated with death than with other outcomes. The nonpain medical conditions present in this analysis included obesity, obstructive sleep apnea, chronic obstructive pulmonary disease, hypertension, and coronary artery disease. Other claims ranged from alleged addiction to opioids from improper prescribing to alleged abandonment with withdrawal of care. The CRICO analysis suggested that patient behavior contributed to over half of these claims, whereas deficits in clinical judgment contributed to approximately 40% of the claims filed. CONCLUSIONS: Claims related to outpatient medication management in pain medicine are multifactorial, stemming from deficits in clinical judgment by physicians, noncooperation in care by patients, and poor clinical documentation. Minimization of both legal risk and patient harm can be achieved by carefully selecting patients for chronic opioid therapy and documenting compliance and improvement with the treatment plan. Medical comorbidities such as obstructive sleep apnea and the use of long-acting opioids may be particularly dangerous. Continuing physician education on the safest and most effective approaches to manage these medications in everyday practice will lead to both improved legal security and patient safety.
[Mh] Termos MeSH primário: Assistência Ambulatorial/legislação & jurisprudência
Analgésicos Opioides/efeitos adversos
Dor Crônica/prevenção & controle
Imperícia/legislação & jurisprudência
Erros Médicos/legislação & jurisprudência
Clínicas de Dor/legislação & jurisprudência
Padrões de Prática Médica/legislação & jurisprudência
Avaliação de Processos (Cuidados de Saúde)/legislação & jurisprudência
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Assistência Ambulatorial/economia
Analgésicos Opioides/administração & dosagem
Causas de Morte
Dor Crônica/diagnóstico
Comorbidade
Compensação e Reparação/legislação & jurisprudência
Bases de Dados Factuais
Feminino
Seres Humanos
Seguro de Responsabilidade Civil/legislação & jurisprudência
Responsabilidade Legal
Masculino
Imperícia/economia
Erros Médicos/economia
Erros Médicos/mortalidade
Meia-Idade
Clínicas de Dor/economia
Medição da Dor
Segurança do Paciente
Padrões de Prática Médica/economia
Avaliação de Processos (Cuidados de Saúde)/economia
Medição de Risco
Fatores de Risco
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002499


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[PMID]:28893894
[Au] Autor:Collier R
[Ad] Endereço:CMAJ.
[Ti] Título:Fees for medical liability protection decrease in populous regions.
[So] Source:CMAJ;189(36):E1174, 2017 09 11.
[Is] ISSN:1488-2329
[Cp] País de publicação:Canada
[La] Idioma:eng
[Mh] Termos MeSH primário: Honorários e Preços/legislação & jurisprudência
Honorários Médicos/tendências
Seguro de Responsabilidade Civil/economia
Responsabilidade Legal/economia
Imperícia/legislação & jurisprudência
[Mh] Termos MeSH secundário: Canadá
Seres Humanos
Imperícia/economia
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170913
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.1095492


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[PMID]:28705065
[Au] Autor:Berlin L
[Ad] Endereço:1 NorthShore University HealthSystem, Department of Radiology, Skokie Hospital, Skokie, IL.
[Ti] Título:Medicolegal-Malpractice and Ethical Issues in Radiology
[So] Source:AJR Am J Roentgenol;209(4):W249-W250, 2017 10.
[Is] ISSN:1546-3141
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Cobertura do Seguro
Seguro de Responsabilidade Civil
Imperícia
Radiologia
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171005
[Lr] Data última revisão:
171005
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170715
[St] Status:MEDLINE
[do] DOI:10.2214/AJR.17.18388


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[PMID]:28586962
[Au] Autor:Marshall D; Tringale K; Connor M; Punglia R; Recht A; Hattangadi-Gluth J
[Ad] Endereço:Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California.
[Ti] Título:Nature of Medical Malpractice Claims Against Radiation Oncologists.
[So] Source:Int J Radiat Oncol Biol Phys;98(1):21-30, 2017 May 01.
[Is] ISSN:1879-355X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To examine characteristics of medical malpractice claims involving radiation oncologists closed during a 10-year period. METHODS AND MATERIALS: Malpractice claims filed against radiation oncologists from 2003 to 2012 collected by a nationwide liability insurance trade association were analyzed. Outcomes included the nature of claims and indemnity payments, including associated presenting diagnoses, procedures, alleged medical errors, and injury severity. We compared the likelihood of a claim resulting in payment in relation to injury severity categories (death as referent) using binomial logistic regression. RESULTS: There were 362 closed claims involving radiation oncology, 102 (28%) of which were paid, resulting in $38 million in indemnity payments. The most common alleged errors included "improper performance" (38% of closed claims, 18% were paid; 29% [$11 million] of total indemnity), "errors in diagnosis" (25% of closed claims, 46% were paid; 44% [$17 million] of total indemnity), and "no medical misadventure" (14% of closed claims, 8% were paid; less than 1% [$148,000] of total indemnity). Another physician was named in 32% of claims, and consent issues/breach of contract were cited in 18%. Claims for injury resulting in death represented 39% of closed claims and 25% of total indemnity. "Improper performance" was the primary alleged error associated with injury resulting in death. Compared with claims involving death, major temporary injury (odds ratio [OR] 2.8, 95% confidence interval [CI] 1.29-5.85, P=.009), significant permanent injury (OR 3.1, 95% CI 1.48-6.46, P=.003), and major permanent injury (OR 5.5, 95% CI 1.89-16.15, P=.002) had a higher likelihood of a claim resulting in indemnity payment. CONCLUSIONS: Improper performance was the most common alleged malpractice error. Claims involving significant or major injury were more likely to be paid than those involving death. Insights into the nature of liability claims against radiation oncologists may help direct efforts to improve quality of care and minimize the risk of being sued.
[Mh] Termos MeSH primário: Seguro de Responsabilidade Civil/economia
Seguro de Responsabilidade Civil/estatística & dados numéricos
Imperícia/estatística & dados numéricos
Erros Médicos/estatística & dados numéricos
Oncologistas/estatística & dados numéricos
Radioterapia (Especialidade)/estatística & dados numéricos
[Mh] Termos MeSH secundário: Seres Humanos
Modelos Logísticos
Imperícia/classificação
Imperícia/economia
Erros Médicos/economia
Erros Médicos/mortalidade
Neoplasias/diagnóstico
Neoplasias/psicologia
Lesões por Radiação/economia
Lesões por Radiação/epidemiologia
Lesões por Radiação/mortalidade
Lesões por Radiação/psicologia
Radioterapia (Especialidade)/economia
Estudos Retrospectivos
Fatores de Tempo
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170721
[Lr] Data última revisão:
170721
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170608
[St] Status:MEDLINE


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[PMID]:28346582
[Au] Autor:Schaffer AC; Jena AB; Seabury SA; Singh H; Chalasani V; Kachalia A
[Ad] Endereço:Division of General Internal Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
[Ti] Título:Rates and Characteristics of Paid Malpractice Claims Among US Physicians by Specialty, 1992-2014.
[So] Source:JAMA Intern Med;177(5):710-718, 2017 May 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Although physician concerns about medical malpractice are substantial, national data are lacking on the rate of claims paid on behalf of US physicians by specialty. Objective: To characterize paid malpractice claims by specialty. Design, Setting, and Participants: A comprehensive analysis was conducted of all paid malpractice claims, with linkage to physician specialty, from the National Practitioner Data Bank from January 1, 1992, to December 31, 2014, a period including an estimated 19.9 million physician-years. All dollar amounts were inflation adjusted to 2014 dollars using the Consumer Price Index. The dates on which this analysis was performed were from May 1, 2015, to February 20, 2016, and from October 25 to December 16, 2016. Main Outcomes and Measures: For malpractice claims (n = 280 368) paid on behalf of physicians (in aggregate and by specialty): rates per physician-year, mean compensation amounts, the concentration of paid claims among a limited number of physicians, the proportion of paid claims that were greater than $1 million, severity of injury, and type of malpractice alleged. Results: From 1992-1996 to 2009-2014, the rate of paid claims decreased by 55.7% (from 20.1 to 8.9 per 1000 physician-years; P < .001), ranging from a 13.5% decrease in cardiology (from 15.6 to 13.5 per 1000 physician-years; P = .15) to a 75.8% decrease in pediatrics (from 9.9 to 2.4 per 1000 physician-years; P < .001). The mean compensation payment was $329 565. The mean payment increased by 23.3%, from $286 751 in 1992-1996 to $353 473 in 2009-2014 (P < .001). The increases ranged from $17 431 in general practice (from $218 350 in 1992-1996 to $235 781 in 2009-2014; P = .36) to $114 410 in gastroenterology (from $276 128 in 1992-1996 to $390 538 in 2009-2014; P < .001) and $138 708 in pathology (from $335 249 in 1992-1996 to $473 957 in 2009-2014; P = .005). Of 280 368 paid claims, 21 271 (7.6%) exceeded $1 million (4304 of 69 617 [6.2%] in 1992-1996 and 4322 of 54 081 [8.0%] in 2009-2014), and 32.1% (35 293 of 109 865) involved a patient death. Diagnostic error was the most common type of allegation, present in 31.8% (35 349 of 111 066) of paid claims, ranging from 3.5% in anesthesiology (153 of 4317) to 87.0% in pathology (915 of 1052). Conclusions and Relevance: Between 1992 and 2014, the rate of malpractice claims paid on behalf of physicians in the United States declined substantially. Mean compensation amounts and the percentage of paid claims exceeding $1 million increased, with wide differences in rates and characteristics across specialties. A better understanding of the causes of variation among specialties in paid malpractice claims may help reduce both patient injury and physicians' risk of liability.
[Mh] Termos MeSH primário: Compensação e Reparação
Seguro de Responsabilidade Civil/tendências
Responsabilidade Legal
Imperícia/tendências
Medicina
Médicos
[Mh] Termos MeSH secundário: Cardiologia
Bases de Dados Factuais
Erros de Diagnóstico
Gastroenterologia
Medicina Geral
Seres Humanos
Patologia Clínica
Pediatria
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170731
[Lr] Data última revisão:
170731
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170328
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.0311


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[PMID]:28255948
[Au] Autor:Kent CD; Stephens LS; Posner KL; Domino KB
[Ad] Endereço:Department of Anesthesiology and Pain Medicine, University of Washington, Box 356540, Seattle, WA, 98195-6540, USA.
[Ti] Título:What Adverse Events and Injuries Are Cited in Anesthesia Malpractice Claims for Nonspine Orthopaedic Surgery?
[So] Source:Clin Orthop Relat Res;475(12):2941-2951, 2017 Dec.
[Is] ISSN:1528-1132
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Malpractice claims that arise during the perioperative care of patients receiving orthopaedic procedures will frequently involve both orthopaedic surgeons and anesthesiologists. The Anesthesia Closed Claims database contains anesthesia malpractice claim data that can be used to investigate patient safety events arising during the care of orthopaedic patients and can provide insight into the medicolegal liability shared by the two specialties. QUESTIONS/PURPOSES: (1) How do orthopaedic anesthetic malpractice claims differ from other anesthesia claims with regard to patient and case characteristics, common events and injuries, and liability profile? (2) What are the characteristics of patients who had neuraxial hematomas after spinal and epidural anesthesia for orthopaedic procedures? (3) What are the characteristics of patients who had orthopaedic anesthesia malpractice claims for central ischemic neurologic injury occurring during shoulder surgery in the beach chair position? (4) What are the characteristics of patients who had malpractice claims for respiratory depression and respiratory arrests in the postoperative period? METHODS: The Anesthesia Closed Claims Project database was the source of data for this study. This national database derives data from a panel of liability companies (national and regional) and includes closed malpractice claims against anesthesiologists representing > 30% of practicing anesthesiologists in the United States from all types of practice settings (hospital, surgery centers, and offices). Claims for damage to teeth or dentures are not included in the database. Patient characteristics, type of anesthesia, damaging events, outcomes, and liability characteristics of anesthesia malpractice claims for events occurring in the years 2000 to 2013 related to nonspine orthopaedic surgery (n = 475) were compared with claims related to other procedures (n = 1592) with p < 0.05 as the criterion for statistical significance and two-tailed tests. Odds ratios and their 95% confidence intervals were calculated for all comparisons. Three types of claims involving high-impact injuries in patients undergoing nonspine orthopaedic surgery were identified through database query for in-depth descriptive review: neuraxial hematoma (n = 10), central ischemic neurologic injury in the beach chair position (n = 9), and injuries caused by postoperative respiratory depression (n = 23). RESULTS: Nonspine orthopaedic anesthesia malpractice claims were more frequently associated with nerve injuries (125 of 475 [26%], odds ratio [OR] 2.12 [1.66-2.71]) and events arising from the use of regional anesthesia (125 of 475 [26%], OR 6.18 (4.59-8.32) than in malpractice claims in other areas of anesthesia malpractice (230 of 1592 [14%] and 87 of 1592 [6%], respectively, p < 0.001 for both comparisons). Ninety percent (nine of 10) of patients with claims for neuraxial hematomas were receiving anticoagulant medication and all had severe long-term injuries, most with a history of significant delay in diagnosis and treatment after first appearance of signs and symptoms. Central ischemic injuries occurring during orthopaedic surgery in the beach chair position did not occur solely in patients who would have been considered at high risk for ischemic stroke. Patients with malpractice claims for injuries resulting from postoperative respiratory depression events had undergone lower extremity procedures (20 of 23 [87%]) and most events (22 of 23 [96%]) occurred on the day of surgery or the first postoperative day. CONCLUSIONS: Nonspine orthopaedic anesthesia malpractice claims more frequently cited nerve injury and events arising from the use of regional anesthesia than other surgical anesthesia malpractice claims. This may reflect the frequency of regional anesthesia in orthopaedic cases rather than increased risk of injury associated with regional techniques. When neuraxial procedures and anticoagulation regimens are used concurrently, care pathways should emphasize clear lines of responsibility for coordination of care and early investigation of any unusual neurologic findings that might indicate neuraxial hematoma. We do not have a good understanding of the factors that render some patients vulnerable to the rare occurrence of intraoperative central ischemic injury in the beach chair position, but providers should carefully calculate cerebral perfusion pressure relative to measured blood pressure for patients in the upright position. Postoperative use of multiple opioids by different concurrent modes of administration warrant special precautions with consideration given to the provision of care in settings with enhanced respiratory monitoring. The limitations of retrospective closed claims database review prevent conclusions regarding causation. Nonetheless, the collection of relatively rare events with substantial clinical detail provides valuable data to generate hypotheses about causation with potential for future study to improve patient safety. LEVEL OF EVIDENCE: Level III, therapeutic study.
[Mh] Termos MeSH primário: Anestesia/efeitos adversos
Seguro de Responsabilidade Civil
Responsabilidade Legal
Imperícia
Procedimentos Ortopédicos/efeitos adversos
Complicações Pós-Operatórias/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Anestesia Epidural/efeitos adversos
Raquianestesia/efeitos adversos
Doenças do Sistema Nervoso Central/etiologia
Distribuição de Qui-Quadrado
Mineração de Dados
Bases de Dados Factuais
Feminino
Hematoma/etiologia
Seres Humanos
Masculino
Meia-Idade
Razão de Chances
Posicionamento do Paciente/efeitos adversos
Insuficiência Respiratória/etiologia
Estudos Retrospectivos
Medição de Risco
Fatores de Risco
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171117
[Lr] Data última revisão:
171117
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170304
[St] Status:MEDLINE
[do] DOI:10.1007/s11999-017-5303-z


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[PMID]:28057702
[Au] Autor:Dyer C
[Ad] Endereço:The BMJ.
[Ti] Título:Gynaecologist is struck off for lying about indemnity cover.
[So] Source:BMJ;356:j72, 2017 01 05.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Decepção
Ginecologia
Seguro de Responsabilidade Civil
Prática Privada/organização & administração
Má Conduta Profissional
[Mh] Termos MeSH secundário: Reino Unido
[Pt] Tipo de publicação:NEWS
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170107
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.j72


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[PMID]:27957689
[Au] Autor:Pu C; Addai B; Pan X; Bo P
[Ad] Endereço:School of Economics, Southwest University for Nationalities, No. 16, Section 4, 1st Ring Road South, Chengdu City, Sichuan Province, 610041, China. Puccy2011@yahoo.com.
[Ti] Título:Securitization product design for China's environmental pollution liability insurance.
[So] Source:Environ Sci Pollut Res Int;24(4):3336-3351, 2017 Feb.
[Is] ISSN:1614-7499
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:The environmental catastrophic accidents in China over the last three decades have triggered implementation of myriad policies by the government to help abate environmental pollution in the country. Consequently, research into environmental pollution liability insurance and how that can stimulate economic growth and the development of financial market in China is worthwhile. This study attempts to design a financial derivative for China's environmental pollution liability insurance to offer strong financial support for significant compensation towards potential catastrophic environmental loss exposures, especially losses from the chemical industry. Assuming the risk-free interest rate is 4%, the market portfolio expected return is 12%; the financial asset beta coefficient is 0.5, by using the capital asset pricing model (CAPM) and cash flow analysis; the principal risk bond yields 9.4%, single-period and two-period prices are 103.85 and 111.58, respectively; the principal partial-risk bond yields 10.09%, single-period and two-period prices are 103.85 and 111.58, respectively; and the principal risk-free bond yields 8.94%, single-period and two-period prices are 107.99 and 115.83, respectively. This loss exposure transfer framework transfers the catastrophic risks of environmental pollution from the traditional insurance and reinsurance markets to the capital market. This strengthens the underwriting capacity of environmental pollution liability insurance companies, mitigates the compensation risks of insurers and reinsurers, and provides a new channel to transfer the risks of environmental pollution.
[Mh] Termos MeSH primário: Poluição Ambiental
[Mh] Termos MeSH secundário: Indústria Química
China
Seguro de Responsabilidade Civil
Probabilidade
Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170525
[Lr] Data última revisão:
170525
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161214
[St] Status:MEDLINE
[do] DOI:10.1007/s11356-016-8172-1


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[PMID]:27723515
[Au] Autor:Tselentis DI; Yannis G; Vlahogianni EI
[Ad] Endereço:National Technical University of Athens, Department of Transportation Planning and Engineering, 5, Iroon Polytechniou Str., Zografou Campus, GR-15773 Athens, Greece. Electronic address: tselentisdimitrios@gmail.com.
[Ti] Título:Innovative motor insurance schemes: A review of current practices and emerging challenges.
[So] Source:Accid Anal Prev;98:139-148, 2017 Jan.
[Is] ISSN:1879-2057
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:The objective of this paper is to provide a review of the most popular and often implemented methodologies related to Usage-based motor insurance (UBI). UBI schemes, such as Pay-as-you-drive (PAYD) and Pay-how-you-drive (PHYD), are a new innovative concept that has recently started to be commercialized around the world. The main idea is that instead of a fixed price, drivers have to pay a premium based on their travel and driving behaviour. Despite the fact that it has been implemented only for a few years, it appears to be a very promising practice with a significant potential impact on traffic safety as well as on traffic congestion mitigation and pollution emissions reduction. To this end, the existing literature on UBI schemes is reviewed and research gaps are identified Findings show that there is a multiplicity and diversity of several research studies accumulated in modern literature examining the correlation between PAYD (based on driver's travel behaviour and exposure) and PHYD (based on driving behaviour) schemes and crash risk in order to determine crash risk. Moreover, there is evidence that UBI implementation would eliminate the cross-subsidies phenomenon, which implies less insurance costs for less risky and exposed drivers. It would also provide a strong motivation for drivers to improve their driving behaviour, differentiate their travel behaviour and reduce their degree of exposure by receiving feedback and monitoring their driving preferences and performance, which would result in crash risk reduction both totally and individually. The paper finally discussed the current and emerging challenges on this research field.
[Mh] Termos MeSH primário: Acidentes de Trânsito/economia
Condução de Veículo/estatística & dados numéricos
Compensação e Reparação
Seguro de Responsabilidade Civil/economia
[Mh] Termos MeSH secundário: Acidentes de Trânsito/prevenção & controle
Seres Humanos
Seguro de Acidentes/classificação
Responsabilidade Legal
Comportamento de Redução do Risco
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1701
[Cu] Atualização por classe:170117
[Lr] Data última revisão:
170117
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161011
[St] Status:MEDLINE


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[PMID]:28032850
[Au] Autor:Ortega Marlasca MM; Saldarreaga Marín JA
[Ad] Endereço:Excelentísimo Colegio Oficial de Médicos de Cádiz, Cádiz, España. Address: Calle Cervantes 12, Cádiz, España. Email: marlasca@makyyo.es.
[Ti] Título:Medical practice, mass media impact and professional insurance guarantee.
[Ti] Título:Ejercicio profesional, repercusión de los medios de comunicación y la garantía de un seguro profesional..
[So] Source:Medwave;16(11):e6806, 2016 Dec 19.
[Is] ISSN:0717-6384
[Cp] País de publicação:Chile
[La] Idioma:spa; eng
[Mh] Termos MeSH primário: Disseminação de Informação/métodos
Seguro de Responsabilidade Civil
Meios de Comunicação de Massa
Médicos/normas
[Mh] Termos MeSH secundário: Seres Humanos
Médicos/economia
Médicos/legislação & jurisprudência
[Pt] Tipo de publicação:LETTER
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170904
[Lr] Data última revisão:
170904
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161230
[St] Status:MEDLINE
[do] DOI:10.5867/medwave.2016.11.6806



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