Malpractice Claims Data as a Quality Improvement Tool

Kravitz, Richard L.; Rolph, John E.; McGuigan, Kimberly A.

doi:10.1001/jama.1991.03470150059031

Cited by 72 publications

(7 citation statements)

References 22 publications

(6 reference statements)

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“…Compared with claims from western countries, the number of medical malpractice claims in Turkey over the six-year period is very small. 3 , 8 – 12 The small number of medical malpractice claims could be due to the lack of awareness of people about health issues. People in Turkey usually leave the right of final decision to doctors on issues concerning the patient due to a paternalist attitude and the huge amount of confidence placed in doctors in Turkey.…”

Section: Discussionmentioning

confidence: 99%

A descriptive study of medical malpractice cases in Turkey

Gündoğmuş

Erdoğan

Şehiraltı

et al. 2005

Annals of Saudi Medicine

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BACKGROUNDMedical malpractice claims in Turkey have increased. We evaluated the problem by describing medical malpractice cases assessed by the Higher Health Council between 1993 and 1998. Our recommendations should help to improve care and decrease medical malpractice claims.METHODSWe reviewed 997 medical malpractice cases reported to the Higher Health Council between 1993 and 1998 and examined the decisions made by the Higher Health Council. We collected data on demographic characteristics, such as the type of the institution where the defendants worked, type of medical malpractice, and medical outcome.RESULTSThere were 997 medical malpractice cases reported to the Higher Health Council in the six years between 1993 and 1998. The Higher Health Council decided that 47.7% of the physicians were liable. Malpractice cases were mostly seen in state hospitals (42.4%). Fifty-nine percent of the cases resulted in death. Among actions that led to malpractice lawsuits against all health care workers, including physicians, the most common were negligence, inappropriate treatment, and diagnostic failure.CONCLUSIONWe think it is necessary to revise the health system and working conditions in hospitals and to develop clinical practice guidelines. We are of the opinion that an emphasis on the use of diagnosis and therapy protocols, standards, post-graduation education, clear and informed patient consent, and improved communication with patients will drastically decrease medical malpractice claims.

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Section: Discussionmentioning

confidence: 99%

A descriptive study of medical malpractice cases in Turkey

Gündoğmuş

Erdoğan

Şehiraltı

et al. 2005

Annals of Saudi Medicine

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“…Latent conditions, also referred to as 'resident pathogens' within the system, reflect decisions made by policymakers and top-level management that define the context within which healthcare practitioners offer their services. In terms of errors on the ground, Kravitz et al [13] differentiate between patient management problems, technical performance inadequacies and failures of teamwork as a result of poor communication between members of the medical and nursing teams. Medicolegal data are being harnessed in various parts of the world to assist with the identification of medicolegal risks and associated opportunities for risk interventions.…”

Section: Researchmentioning

confidence: 99%

A retrospective, observational study of medicolegal cases against obstetricians and gynaecologists in South Africa’s private sector

Taylor

Cleary

2021

S Afr Med J

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Background. The viability of obstetric practice in the private sector has been threatened as a result of steep increases in professional indemnity fees over the past 10 years. Despite this, empirical research investigating key aetiological factors to target risk management interventions has been lacking. Objectives. To explore private practice medicolegal data linked to obstetricians and gynaecologists (O&Gs) to identify factors in clinical practice associated with claims, for the purposes of guiding future research and risk management solutions. Methods. This was a retrospective, observational study of private sector O&Gs' medicolegal case histories. All incidents declared to a prominent local professional indemnity insurer were categorised in terms of medicolegal case type, as well as clinical parameters. To allow for risk-adjusted calculations of case incidence, year of entry into private practice was estimated for all practitioners. Results. Steep increases in medicolegal investigations and demands were demonstrated for both obstetrics-and gynaecology-related cases from about 2003 to 2012. Whereas the total numbers of claims, regulatory complaints and requests for records were similar for obstetrics and gynaecology in recent years (accounting for 52% v. 48% of known cases, respectively), a significantly greater percentage of demands and paid settlements related to gynaecology rather than obstetrics (58% and 76% v. 42% and 24% of cases, respectively). In obstetrics, about half of all cases on record with a paid settlement were in the context of severe neonatal birth-related neurological injury (n=9). For gynaecology, procedure-related complications accounted for 92% of settlements, of which at least 41% were for intraoperative injuries to internal organs and vessels. Laparoscopic procedures were most frequently associated with such intraoperative injuries, followed by vaginal and abdominal hysterectomies/oophorectomies and caesarean sections. For O&Gs in private practice for >2 years, 50/458 (11%) accounted for 138/228 (61%) of demands over a 10-year period. Conclusions. The higher number of gynaecological demands and settlements in comparison with obstetric cases was unexpected and is contrary to international experiences and public sector findings, calling for more research to identify reasons for this finding. Other than further exploring surgical outcomes in private sector gynaecological patients, aspects of surgical training and accreditation standards in gynaecology may need review. Regarding birth-related injuries, the contribution of system failures needs quantification and further interrogation. The high contribution towards the medicolegal burden by a small group of practitioners suggests a need for doctor-focused interventions, including strengthening of peer review and regulatory oversight.

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“…One reason is that patients, for various reasons, tend not to complain or file a malpractice claim about their grievances. 30 A second reason is that complaints may not be concentrated enough, e.g., to develop targeted interventions at specific members of staff, 31 although a recent study found that 3% of Australian doctors accounted for 49% of the formal complaints registered during 2000-2011. 32 Besides complaining, Anna could also voice her concerns in patient surveys, but this might not lead to any changes in Ingrid's behaviour or at the clinic.…”

Section: Possible Consequences For Care Qualitymentioning

confidence: 99%