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Abstract：
BACKGROUND: Physicians who perform unsafe practices and harm patients may be disciplined. In Norway, there are five types of disciplinary action, ranging from a warning for the least serious examples of malpractice to loss of licence for the most serious ones. Disciplinary actions always involve medical malpractice. The aims of this study were to investigate the frequency and distribution of disciplinary actions by the Norwegian Board of Health Supervision for doctors in Norway and to uncover nation-wide patient safety issues.
METHODS: We retrospectively investigated all 953 disciplinary actions for doctors given by the Board between 2011 and 2018. We categorized these according to type of action, recipient\'s profession, organizational factors and geographical location of the recipient. Frequencies, cross tables, rates and linear regression were used for statistical analysis.
RESULTS: Rural general practitioners received the most disciplinary actions of all doctors and had their licence revoked or restricted 2.1 times more frequently than urban general practitioners. General practitioners and private specialists received respectively 98.7 and 91.0 disciplinary actions per 1000 doctors. Senior consultants and junior doctors working in hospitals received respectively 17.0 and 6.4 disciplinary actions per 1000 doctors. Eight times more actions were received by primary care doctors than secondary care doctors. Doctors working in primary care were given a warning 10.6 times more often and had their licence revoked or restricted 4.6 times more often than those in secondary care.
CONCLUSIONS: The distribution and frequency of disciplinary actions by the Norwegian Board of Health Supervision clearly varied according to type of health care facility. Private specialists and general practitioners, especially those working in rural clinics, received the most disciplinary actions. These results deserve attention from health policy-makers and warrant further studies to determine the factors that influence medical malpractice. Moreover, the supervisory authorities should assess whether their procedures for reacting to malpractice are efficient and adequate for all types of physicians working in Norway.
METHODS: We retrospectively investigated all 953 disciplinary actions for doctors given by the Board between 2011 and 2018. We categorized these according to type of action, recipient\'s profession, organizational factors and geographical location of the recipient. Frequencies, cross tables, rates and linear regression were used for statistical analysis.
RESULTS: Rural general practitioners received the most disciplinary actions of all doctors and had their licence revoked or restricted 2.1 times more frequently than urban general practitioners. General practitioners and private specialists received respectively 98.7 and 91.0 disciplinary actions per 1000 doctors. Senior consultants and junior doctors working in hospitals received respectively 17.0 and 6.4 disciplinary actions per 1000 doctors. Eight times more actions were received by primary care doctors than secondary care doctors. Doctors working in primary care were given a warning 10.6 times more often and had their licence revoked or restricted 4.6 times more often than those in secondary care.
CONCLUSIONS: The distribution and frequency of disciplinary actions by the Norwegian Board of Health Supervision clearly varied according to type of health care facility. Private specialists and general practitioners, especially those working in rural clinics, received the most disciplinary actions. These results deserve attention from health policy-makers and warrant further studies to determine the factors that influence medical malpractice. Moreover, the supervisory authorities should assess whether their procedures for reacting to malpractice are efficient and adequate for all types of physicians working in Norway.
摘要：
背景：执行不安全操作并伤害患者的医生可能会受到纪律处分。在挪威,有五种类型的纪律处分，从警告最不严重的渎职行为到最严重的失照。纪律处分总是涉及医疗事故。这项研究的目的是调查挪威卫生监督委员会对挪威医生的纪律处分的频率和分布，并发现全国范围内的患者安全问题。
方法：我们回顾性调查了委员会在2011年至2018年期间对医生的所有953项纪律处分。我们根据行动的类型对这些进行了分类，收件人的职业，收件人的组织因素和地理位置。频率,交叉表,率和线性回归用于统计分析.
结果：农村全科医生在所有医生中受到的纪律处分最多，其执照被吊销或限制的频率是城市全科医生的2.1倍。全科医生和私人专家每1000名医生分别受到98.7和91.0项纪律处分。在医院工作的高级顾问和初级医生每1000名医生分别受到17.0和6.4项纪律处分。初级保健医生收到的行动是二级保健医生的八倍。在初级保健工作的医生比在二级保健工作的医生获得警告的频率高10.6倍，被吊销或限制执照的频率高4.6倍。
结论：挪威卫生监督委员会的纪律处分的分布和频率根据医疗机构的类型而明显不同。私人专家和全科医生，尤其是那些在农村诊所工作的人，受到的纪律处分最多。这些结果值得卫生政策制定者的关注，并需要进一步研究以确定影响医疗事故的因素。此外，监管当局应评估其应对医疗事故的程序是否有效，是否适合在挪威工作的所有类型的医生。
方法：我们回顾性调查了委员会在2011年至2018年期间对医生的所有953项纪律处分。我们根据行动的类型对这些进行了分类，收件人的职业，收件人的组织因素和地理位置。频率,交叉表,率和线性回归用于统计分析.
结果：农村全科医生在所有医生中受到的纪律处分最多，其执照被吊销或限制的频率是城市全科医生的2.1倍。全科医生和私人专家每1000名医生分别受到98.7和91.0项纪律处分。在医院工作的高级顾问和初级医生每1000名医生分别受到17.0和6.4项纪律处分。初级保健医生收到的行动是二级保健医生的八倍。在初级保健工作的医生比在二级保健工作的医生获得警告的频率高10.6倍，被吊销或限制执照的频率高4.6倍。
结论：挪威卫生监督委员会的纪律处分的分布和频率根据医疗机构的类型而明显不同。私人专家和全科医生，尤其是那些在农村诊所工作的人，受到的纪律处分最多。这些结果值得卫生政策制定者的关注，并需要进一步研究以确定影响医疗事故的因素。此外，监管当局应评估其应对医疗事故的程序是否有效，是否适合在挪威工作的所有类型的医生。
