Objective This study aimed to investigate the malpractice claims experienced by orthopedic and traumatology physicians and to determine their effects on burnout, job satisfaction, and clinical practice. Methods A questionnaire survey was conducted on orthopedic and traumatology specialists between May 2019 and February 2020. Data collection was carried out via e-survey at “turk-ortopedi” mail group, which is an electronic communication network of orthopedic and traumatology physicians. For data collection, sociodemographic data forms were used including the general characteristics, working conditions, and the malpractice claim events along with the Maslach Burnout Inventory scale to evaluate burnout and the Minnesota Satisfaction Questionnaire to investigate job satisfaction. Results In total, 353 orthopedic and traumatology physicians (348 men, 5 women), including 37 professors, 41 associate professors, and 275 surgeons, completed the questionnaire. In total, 65.4% of the participants (231 physicians and 471 relevant dossiers) stated that they were currently facing a malpractice claim. Emotional burnout and hesitant behavior in medical practices were significantly higher among the physicians who had undergone an investigation/trial with the claim of malpractice (p<0.05), whereas intrinsic job satisfaction was significantly lower (p<0.05). It was determined that orthopedic and traumatology physicians dealing with arthroplasty, vertebral surgery, hand surgery, and foot/ankle surgeries had undergone significantly more trials (p<0.05). In the evaluation of the burnout levels and job satisfaction scores of the physicians according to the age, academic title, seniority, and institution, it was determined that burnout level decreased with age, those between the ages of 25 and 34 years were exhausted the most, and job satisfaction increased with age. It was also found that burnout level decreased and job satisfaction increased as the academic title became higher, and attending physicians were the most exhausted. Moreover, burnout level decreased as seniority increased, the most senior ones were the ones most exhausted, and job satisfaction increased with seniority. Conclusion Evidence from this study has revealed that malpractice claims cause emotional burnout, low intrinsic job satisfaction, and a hesitant behavior in medical practice for the orthopedic and traumatology physicians. The concept of malpractice alone may result in unnecessary analyses/examinations for patients. Level of Evidence Level IV, Diagnostic Study
This study aimed to investigate the costs covered by the hospital during inpatient treatment of patients who underwent knee revision arthroplasty in the orthopedics and traumatology clinics of a public hospital and compare with the invoiced amount. Methods: The demographic information and revision reasons of 50 patients who underwent total knee revision arthroplasty in a public hospital between 01.01.2016 and 30.09.2017 were determined using hospital information management system records. The patients were categorized into two groups: septic and aseptic. For each patient, the costs of medical consumables, medicine/serum, medical treatment, surgery, anesthesia, imaging services, laboratory procedures, blood and blood products, meal and companion costs, device depreciation expenses, consultation, control examination, preoperative patient preparation stage, surgery, visit and other costs were calculated separately during inpatient treatment. Results: The average total cost of a patient was 24,005.00 TL, whereas the average invoice amount was 21,490.00 TL, with a difference of 2,515.00 TL. This difference was 3,193.00 TL and 2,166.00 TL in the septic and aseptic groups, respectively. In the septic group, the duration of hospital stay, medication, treatment, surgery, anesthesia, laboratory, imaging, blood center, consultation, visit, meal cost, total cost, and invoice amount were significantly higher than the aseptic group (p˂0.05). Conclusion: Regulations by the social security institution are needed to ensure the fiscal sustainability of the public hospital's. In addition, following the medical and technical innovations in revision surgery can help reduce the costs.
<p><strong>Background:</strong> During the COVID-19 pandemic period, resources should be reorganized to treat the increased burden of COVID-positive patients under the best conditions while simultaneously providing non-deferrable treatment to patients with no suspicion of COVID-19. In this study, we aimed to analyse the trauma patient profile and treatment strategies that emerged in the regional orthopaedic and traumatology hospital during the pandemic period after the implementation of “hub and spoke” organization among the orthopaedic and traumatology clinics.</p><p><strong>Methods:</strong> This cross-observational study was conducted in a training and research hospital in the field of orthopaedics and traumatology that was converted to a non-COVID referral orthopaedic trauma center during the pandemic. Gender, age, length of hospitalization, duration of trauma, place of trauma, severity of trauma, type of admission, type of anaesthesia and site of trauma were evaluated in the patients that presented between March 16 and May 16, 2020.</p><p><strong>Results:</strong> Of the orthopaedic trauma patients requiring surgery, 169 (62.6%) were men and 101 (37.4%) were women. In comparison of the data with that of the last year, significant increases were observed in the number of home traumas (241.5%), low-energy traumas (87.4%), patients referred from other institutions (328.9%), regional anaesthesia patients (124.2%) and patients with hip traumas (226.7%). The length of hospitalization decreased significantly (p<0.05).</p><p><strong>Conclusions:</strong> The creation of hub and spoke organization through the cooperation of orthopaedics and traumatology clinics in the region can reduce the burden on pandemic hospitals by isolating trauma patients requiring orthopaedic surgery who were not suspected of COVID-19 and directing them to dedicated orthopaedics and traumatology hospital.</p>
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