Chun-Ying Wu1, Huei-Jen Lai, Rong-Chi Chen. 1. Division of Gastroenterology, Taichung Veterans General Hospital, and Law Department, Social Science College, Tunghai University, Taichung, Taiwan.
Abstract
BACKGROUND/ PURPOSE: A better understanding of the risk factors for medical malpractice is essential for implementing long-term prevention strategies. Certain physician characteristics have been reported to be associated with malpractice litigation. However, patient characteristics have not been fully investigated. METHODS: We conducted a hospital-based case-control study. We reviewed a total of 147 cases in the inpatient risk management file (RMF) and 44,045 inpatient controls. The RMF was opened if the patient's complaint may have led to legal action. We compared demographic data of RMF cases and controls to investigate the risk factors for filing a complaint. Outcomes of the RMF cases were classified as resolution, compensation, and lawsuit. RESULTS: RMF cases were associated with admission via the emergency room (odds ratio [OR]=1.62, p=0.005), surgical specialty (OR=1.86, p=0.001) and living in an urban area (OR=1.93, p<0.001). Once RMF cases were filed, living in an urban area was the only independent factor for filing a lawsuit (OR=4.10, p=0.007). RMF cases with medical injury were more likely to reach compensation (OR=10.51, p<0.001) and to receive significantly higher compensation (p=0.007). The severity of medical injury was correlated positively with the likelihood of reaching compensation and the amount of compensation. Only 15.0% of RMF cases entered the litigation phase. CONCLUSION: Patients with certain characteristics tend to file complaints, receive compensation, or bring a case to court. Understanding of patient characteristics may be useful for predicting occurrence and outcome of complaints against physicians.
BACKGROUND/ PURPOSE: A better understanding of the risk factors for medical malpractice is essential for implementing long-term prevention strategies. Certain physician characteristics have been reported to be associated with malpractice litigation. However, patient characteristics have not been fully investigated. METHODS: We conducted a hospital-based case-control study. We reviewed a total of 147 cases in the inpatient risk management file (RMF) and 44,045 inpatient controls. The RMF was opened if the patient's complaint may have led to legal action. We compared demographic data of RMF cases and controls to investigate the risk factors for filing a complaint. Outcomes of the RMF cases were classified as resolution, compensation, and lawsuit. RESULTS: RMF cases were associated with admission via the emergency room (odds ratio [OR]=1.62, p=0.005), surgical specialty (OR=1.86, p=0.001) and living in an urban area (OR=1.93, p<0.001). Once RMF cases were filed, living in an urban area was the only independent factor for filing a lawsuit (OR=4.10, p=0.007). RMF cases with medical injury were more likely to reach compensation (OR=10.51, p<0.001) and to receive significantly higher compensation (p=0.007). The severity of medical injury was correlated positively with the likelihood of reaching compensation and the amount of compensation. Only 15.0% of RMF cases entered the litigation phase. CONCLUSION:Patients with certain characteristics tend to file complaints, receive compensation, or bring a case to court. Understanding of patient characteristics may be useful for predicting occurrence and outcome of complaints against physicians.
Authors: Jackie van Dael; Tom W Reader; Alex Gillespie; Ana Luisa Neves; Ara Darzi; Erik K Mayer Journal: BMJ Qual Saf Date: 2020-02-04 Impact factor: 7.035