A national survey on“defensive medical examination”

Objective: To understand the general situation and dynamic changes of defensive medical examinations in 136 major tertiary public hospitals in China.

Methods: Since 2016, we conducted annual China Healthcare ImprovementEvaluation Survey(CHIES) among nearly 40 000 health professionals from 136 tertiary public hospitals in 31 provinces across the country. This study focuses on the self-reported prevalence of one survey item “In order to avoid medical disputes, it’s common for doctors to provide unnecessary examinations” as an indicator of defensive medical examinations.

Results: Between 2016-2018, the overall agreement among doctors and nurses on defensive medical examinations were 13.1%, 24% and 16.3% respectively. The doctors’ agreement rates(16%, 28.4%, and 21.6%) were higher than that of the nurses(10.3%, 20.3%, and 12.1%) and the upward trend of self-reported defensive medical examinations were apparent among both doctors and nurses.

Conclusions: Compared with some international surveys, the agreement rates of health professionals on defensive medical examinations were not high in major tertiary public hospitals in China, but the upward trend over past three years raise concerns.

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