PDF(Pubmed)
Abstract：
OBJECTIVE: Several studies have been carried out on defensive medicine, but research from the managerial viewpoint is still scarce. Therefore, the aim of the present study is to conduct a literature review to better understand defensive medicine from a managerial perspective.
METHODS: A literature review was conducted of studies focusing on the organisational (meso) level of healthcare providers and managerial practices. A final sample of 28 studies was processed.
RESULTS: Defensive medicine has mainly been studied in the USA, and scholars have principally used quantitative surveys. High-risk specialities have been a critical field of investigation, and a large portion of the papers are published in journals that cover medicine, health policy, education and law fields. The analysis showed that operations and the organisation of staffing were the most discussed managerial practices. No study considered planning and budgeting aspects.
CONCLUSIONS: The review confirmed that the managerial aspect of defensive medicine has not been fully addressed. Stimulated by this gap, this study analyses the managerial background of the defensive medicine phenomenon and shows which managerial practices have been most analysed. This paper also contributes to developing the literature on defensive medicine from the managerial side. Areas for future research include qualitative studies to investigate the behaviour of managers of healthcare companies to give a different perspective on defensive medicine and organisations\' decision-making.
CONCLUSIONS: Some important publications might have been missed in this work because of the choice of only two databases. A further limit could be imposed by the use of the English language as an inclusion criterion.
METHODS: A literature review was conducted of studies focusing on the organisational (meso) level of healthcare providers and managerial practices. A final sample of 28 studies was processed.
RESULTS: Defensive medicine has mainly been studied in the USA, and scholars have principally used quantitative surveys. High-risk specialities have been a critical field of investigation, and a large portion of the papers are published in journals that cover medicine, health policy, education and law fields. The analysis showed that operations and the organisation of staffing were the most discussed managerial practices. No study considered planning and budgeting aspects.
CONCLUSIONS: The review confirmed that the managerial aspect of defensive medicine has not been fully addressed. Stimulated by this gap, this study analyses the managerial background of the defensive medicine phenomenon and shows which managerial practices have been most analysed. This paper also contributes to developing the literature on defensive medicine from the managerial side. Areas for future research include qualitative studies to investigate the behaviour of managers of healthcare companies to give a different perspective on defensive medicine and organisations\' decision-making.
CONCLUSIONS: Some important publications might have been missed in this work because of the choice of only two databases. A further limit could be imposed by the use of the English language as an inclusion criterion.
摘要：
目的：已经对防御医学进行了几项研究，但是从管理角度进行的研究仍然很少。因此,本研究的目的是进行文献综述，从管理的角度更好地理解防御医学。
方法：针对医疗保健提供者的组织（中观）水平和管理实践进行了文献综述。处理了28项研究的最终样本。
结果：防御医学主要在美国进行研究，学者主要使用定量调查。高风险专业一直是一个关键的调查领域，大部分论文发表在涵盖医学的期刊上，卫生政策,教育和法律领域。分析表明，运营和人员配置是讨论最多的管理实践。没有研究考虑规划和预算方面。
结论：审查证实，防御性医学的管理方面尚未得到充分解决。受到这种差距的刺激，这项研究分析了防御性医学现象的管理背景，并显示了分析最多的管理实践。本文还有助于从管理方面发展防御性医学的文献。未来研究的领域包括定性研究，以调查医疗保健公司经理的行为，从而对防御性医学和组织的决策提出不同的看法。
结论：由于仅选择了两个数据库，因此这项工作可能错过了一些重要的出版物。可以通过使用英语作为纳入标准来施加进一步的限制。
方法：针对医疗保健提供者的组织（中观）水平和管理实践进行了文献综述。处理了28项研究的最终样本。
结果：防御医学主要在美国进行研究，学者主要使用定量调查。高风险专业一直是一个关键的调查领域，大部分论文发表在涵盖医学的期刊上，卫生政策,教育和法律领域。分析表明，运营和人员配置是讨论最多的管理实践。没有研究考虑规划和预算方面。
结论：审查证实，防御性医学的管理方面尚未得到充分解决。受到这种差距的刺激，这项研究分析了防御性医学现象的管理背景，并显示了分析最多的管理实践。本文还有助于从管理方面发展防御性医学的文献。未来研究的领域包括定性研究，以调查医疗保健公司经理的行为，从而对防御性医学和组织的决策提出不同的看法。
结论：由于仅选择了两个数据库，因此这项工作可能错过了一些重要的出版物。可以通过使用英语作为纳入标准来施加进一步的限制。
