A Theissen1, F Fuz2, J Catineau3, W Sultan3, M Beaussier4, M Carles5, M Raucoules-Aimé5, P Niccolai6. 1. Service d'anesthésie réanimation, centre hospitalier Princesse Grace, 1, avenue Pasteur, 98010 Monaco, Monaco. Electronic address: alexandretheissen@hotmail.com. 2. SHAM, service gestion des risques, 18, rue Édouard-Rochet, 69372 Lyon cedex 08, France. 3. Service d'anesthésie réanimation, centre hospitalier Princesse Grace, 1, avenue Pasteur, 98010 Monaco, Monaco. 4. Unité de chirurgie ambulatoire, département d'anesthésie réanimation, hôpital Saint-Antoine, 184, rue du Faubourg Saint-Antoine, 75571 Paris cedex12, France. 5. Service d'anesthésie réanimation, hôpital de l'Archet, CHU de Nice, 06202 Nice cedex 3, France. 6. Service d'anesthésie et chirurgie ambulatoire, centre hospitalier Princesse Grace, 1, avenue Pasteur, 98010 Monaco, Monaco.
Abstract
UNLABELLED: The medico-legal risk specifically associated with the practice of ambulatory surgery is still not well studied. SHAM insurances are the biggest French provider of medical liability insurances. The study of the insurance claims provided by this insurer is therefore a relevant source of data on the complications related to ambulatory surgery. OBJECTIVE: The aim of this study was to compare the claim rate related to ambulatory surgery with non-ambulatory surgery. STUDY DESIGN: We did a retrospective study on insurance claims provided by SHAM insurances between 2007 and 2011 to compare the claim rate related to ambulatory surgery with non-ambulatory surgery. MATERIALS AND METHODS: We searched the files in the SHAM database, and then analyzed them. RESULTS: On the study period, out of a total of 29565 registered claims, 467 (1.6%) originated from ambulatory surgery. On the total of 29,098 registered claims for non-ambulatory surgery, 2151 (7.4%) led to a condemnation whereas the rate was 7% (33 out of 467 claims) for ambulatory surgery. The condemnations linked to ambulatory surgery amounted to 1.5% of the total (33 out of 2184), for a cost of 1.7 M€ (versus 400,3 M€ for non-ambulatory surgery). The average cost of a compensation is therefore 50,500 € for ambulatory surgery and 186,000 € for non-ambulatory surgery. The medical specialties concerned are primarily ophthalmology, abdominal and orthopedics surgery. The main identified causes were medical errors (n=16) and nosocomial infections (n=13). CONCLUSIONS: The claim rate in ambulatory surgery is proportionally less frequent with compensations three times less and were related to the most frequent type of surgery done in ambulatory settings. These data should help strengthen quality approach in ambulatory surgery.
UNLABELLED: The medico-legal risk specifically associated with the practice of ambulatory surgery is still not well studied. SHAM insurances are the biggest French provider of medical liability insurances. The study of the insurance claims provided by this insurer is therefore a relevant source of data on the complications related to ambulatory surgery. OBJECTIVE: The aim of this study was to compare the claim rate related to ambulatory surgery with non-ambulatory surgery. STUDY DESIGN: We did a retrospective study on insurance claims provided by SHAM insurances between 2007 and 2011 to compare the claim rate related to ambulatory surgery with non-ambulatory surgery. MATERIALS AND METHODS: We searched the files in the SHAM database, and then analyzed them. RESULTS: On the study period, out of a total of 29565 registered claims, 467 (1.6%) originated from ambulatory surgery. On the total of 29,098 registered claims for non-ambulatory surgery, 2151 (7.4%) led to a condemnation whereas the rate was 7% (33 out of 467 claims) for ambulatory surgery. The condemnations linked to ambulatory surgery amounted to 1.5% of the total (33 out of 2184), for a cost of 1.7 M€ (versus 400,3 M€ for non-ambulatory surgery). The average cost of a compensation is therefore 50,500 € for ambulatory surgery and 186,000 € for non-ambulatory surgery. The medical specialties concerned are primarily ophthalmology, abdominal and orthopedics surgery. The main identified causes were medical errors (n=16) and nosocomial infections (n=13). CONCLUSIONS: The claim rate in ambulatory surgery is proportionally less frequent with compensations three times less and were related to the most frequent type of surgery done in ambulatory settings. These data should help strengthen quality approach in ambulatory surgery.