Changes in compensation claim contents following reorganization of emergency hospital care.

Autor:	Birkeland S; Department of Clinical Medicine, (OPEN) University of Southern Denmark, J. B. Winsløws Vej 9a, 3rd floor, DK-5000 Odense C, Denmark., Brabrand M; Department of Emergency Medicine, University of Southern Denmark, Kløvervænget 25-25C, DK-5000 Odense C, Denmark., Mikkelsen KL; The Danish Patient Compensation Association, Kalvebod Brygge 45, DK-1560 Copenhagen V, Denmark., Bie Bogh S; Department of Clinical Medicine, (OPEN) University of Southern Denmark, J. B. Winsløws Vej 9a, 3rd floor, DK-5000 Odense C, Denmark.
Jazyk:	angličtina
Zdroj:	International journal for quality in health care : journal of the International Society for Quality in Health Care [Int J Qual Health Care] 2020 Dec 15; Vol. 32 (10), pp. 685-693.
DOI:	10.1093/intqhc/mzaa131
Abstrakt:	Objectives: To study the effects of the reorganization on patient compensation claim contents relating to health care quality and patient safety. Design and Settings: Danish emergency care has developed considerably over the past decades, including a major reorganization to improve health care quality and patient safety through ensuring easier access to specialist treatment. Analysis of compensation claim patterns is used to evaluate the effects of such health care system changes. Participants, Interventions and Main Outcome Measures: A sample of 1613 compensation claims to the Danish Patient Assurance organization was reviewed using a standardized taxonomy (the Healthcare Complaints Analysis Tool [HCAT]). Using trend analysis, we compared the proportions of claims categorized under HCAT domains, problem categories and sub-categories before and after the reorganization, with particular emphasis on the 'Clinical problems' domain covering health care quality and patient safety issues. Results: We observed a baseline increase in claims relating to clinical problems (P < 0.01), but this increase was less pronounced following the reorganization. This appeared to be driven mainly by a decrease in claims about clinician skills (P = 0.03) and health care neglects (P = 0.01). However, claims about diagnostic errors and patient outcomes showed a tendency (insignificant) to increase. Conclusions: Emergency care reorganization apparently has been followed by a shift in claim contents towards fewer claims about health care neglect and staff competencies, although claims about other matters may have become more common. Present analyses of compensation claim trends should be supplemented by effect studies using traditional outcome measures such as mortality and readmission rates. (© The Author(s) 2020. Published by Oxford University Press on behalf of International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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