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[PMID]:29231666
[Au] Autor:Bratlid D
[Ti] Título:Is the Norwegian System of Patient Injury Compensation in the best interests of patients?
[Ti] Título:Er pasientene tjent med Norsk pasientskadeerstatning?.
[So] Source:Tidsskr Nor Laegeforen;137(23-24), 2017 12 12.
[Is] ISSN:0807-7096
[Cp] País de publicação:Norway
[La] Idioma:eng; nor
[Mh] Termos MeSH primário: Compensação e Reparação
Revisão da Utilização de Seguros/organização & administração
[Mh] Termos MeSH secundário: Competência Clínica
Seres Humanos
Imperícia/economia
Erros Médicos/economia
Erros Médicos/legislação & jurisprudência
Noruega
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171213
[St] Status:MEDLINE
[do] DOI:10.4045/tidsskr.17.0340


  2 / 2703 MEDLINE  
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[PMID]:28464812
[Au] Autor:Murgatroyd D; Harris IA; Chen JS; Adie S; Mittal R; Cameron ID
[Ad] Endereço:John Walsh Centre for Rehabilitation Research, The University of Sydney, Kolling Institute, Sydney, NSW, Australia. dmur0062@uni.sydney.edu.au.
[Ti] Título:Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries.
[So] Source:BMC Musculoskelet Disord;18(1):177, 2017 05 02.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Compensation related factors have been repeatedly associated with poor recovery following orthopaedic trauma. There is limited research into the factors associated with seeking financial compensation. Further understanding of these factors could facilitate injury recovery by purposeful compensation scheme design. The aim of this study was to investigate the predictors of seeking financial compensation, namely making a claim and seeking legal representation, following motor vehicle related orthopaedic trauma. The study was conducted in New South Wales (NSW), Australia, in motor vehicle crash and workers' compensation schemes. METHODS: Participants were patients admitted with upper or lower extremity factures following a motor vehicle crash to two trauma hospitals. Data were collected at baseline within two weeks of injury. Participants were followed up at six months. Analysis involved: descriptive statistics for baseline characteristics; comparison of compensable and non-compensable participants with Analysis of Variance (ANOVA) and chi-squared tests; and logistic regression for predictor models. RESULTS: The cohort consisted of 452 participants with a mean age 40 years; 75% male; 74% working pre-injury; 30% in excellent pre-injury health; 56% sustained serious injuries with an Injury Severity Score (ISS) 9-15; 61% had a low-middle range household income; and 35% self-reported at fault in the crash. There was no significant difference in pre-injury/baseline health between compensable and non-compensable participants. Follow up data was available for 301 (67%) participants. The significant predictor of claiming compensation in the adjusted analysis was higher body mass index (BMI) (overweight Odds Ratio [OR] 3.05, 95% Confidence Interval [CI] 1.63-5.68; obese OR 1.63, 95% CI 0.83-3.20). Participants less likely to claim were: involved in a motorcycle crash (OR 0.47, 95% CI 0.28-0.82); socioeconomically less disadvantaged (OR 0.37, 95% CI 0.17-0.82) or least disadvantaged (OR 0.39, 95% CI 0.17-0.90); at risk for short term harm (injury) due to alcohol consumption (OR 0.56, 95% CI 0.32-0.97); and with fair-poor pre-injury health (OR 0.30, 95% CI 0.09-0.94). The predictors for seeking legal representation were speaking a language other than English at home (OR 2.80, 95% CI 1.2-6.52) and lower household income (OR 3.63, 95% CI 1.22-10.72). Participants less likely to seek legal representation were least socioeconomically disadvantaged (OR 0.15, 95% CI 0.04-0.50). CONCLUSIONS: Seeking financial compensation was associated with a higher pre-injury BMI rather than injury-related factors. Seeking legal representation was solely related to socio-economic factors.
[Mh] Termos MeSH primário: Acidentes de Trânsito/economia
Compensação e Reparação
Sistema Musculoesquelético/lesões
Ferimentos e Lesões/economia
[Mh] Termos MeSH secundário: Acidentes de Trânsito/legislação & jurisprudência
Adolescente
Adulto
Idoso
Idoso de 80 Anos ou mais
Automóveis
Índice de Massa Corporal
Compensação e Reparação/legislação & jurisprudência
Grupos Étnicos
Feminino
Seres Humanos
Renda
Serviços Jurídicos
Masculino
Meia-Idade
Motocicletas
New South Wales
Recuperação de Função Fisiológica
Fatores Socioeconômicos
Populações Vulneráveis
Ferimentos e Lesões/etiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180306
[Lr] Data última revisão:
180306
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE
[do] DOI:10.1186/s12891-017-1535-z


  3 / 2703 MEDLINE  
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[PMID]:28453790
[Au] Autor:Manning JM
[Ad] Endereço:Faculty of Law, University of Auckland, Auckland, New Zealand.
[Ti] Título:Does the Law on Compensation for Research-Related Injury in the UK, Australia, and New Zealand Meet Ethical Requirements?
[So] Source:Med Law Rev;25(3):397-427, 2017 Aug 01.
[Is] ISSN:1464-3790
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Despite a consensus that society owes an ethical obligation to compensate for research-related injury, and that no-fault is the best ethical response, an assessment of the compensation arrangements in place in the UK, Australia and New Zealand shows that in general compensation arrangements fall below this ethical expectation. Most subjects rely on ex gratia payment or an unenforceable assurance of payment in the event of injury. It is also likely that, given significant deficiencies in participant information about compensation arrangements in place for trials recommended by the supervisory ethics agencies in each jurisdiction, subjects only find out about their financial exposure in the event of injury. Industry-drafted guidelines governing compensation in commercially sponsored trials do not protect subjects' interests, but operate primarily to protect the interests of industry. The article considers potential solutions to the ethical deficiency of the compensation arrangements, and argues that the ethical corollary of the fact that society is the ultimate beneficiary of its members' participation in clinical research, is that society as a whole should bear the cost of participant injuries, through establishment of a central no-fault compensation fund financed either by the state or those directly involved in biomedical research.
[Mh] Termos MeSH primário: Compensação e Reparação/ética
Sujeitos da Pesquisa
[Mh] Termos MeSH secundário: Austrália
Seres Humanos
Consentimento Livre e Esclarecido
Princípios Morais
Nova Zelândia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE
[do] DOI:10.1093/medlaw/fwx019


  4 / 2703 MEDLINE  
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[PMID]:29052704
[Au] Autor:Moore J; Bismark M; Mello MM
[Ad] Endereço:Faculty of Law, University of New South Wales, Sydney, Australia.
[Ti] Título:Patients' Experiences With Communication-and-Resolution Programs After Medical Injury.
[So] Source:JAMA Intern Med;177(11):1595-1603, 2017 Nov 01.
[Is] ISSN:2168-6114
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Dissatisfaction with medical malpractice litigation has stimulated interest by health care organizations in developing alternatives to meet patients' needs after medical injury. In communication-and-resolution programs (CRPs), hospitals and liability insurers communicate with patients about adverse events, use investigation findings to improve patient safety, and offer compensation when substandard care caused harm. Despite increasing interest in this approach, little is known about patients' and family members' experiences with CRPs. Objective: To explore the experiences of patients and family members with medical injuries and CRPs to understand different aspects of institutional responses to injury that promoted and impeded reconciliation. Design, Setting, and Participants: From January 6 through June 30, 2016, semistructured interviews were conducted with patients (n = 27), family members (n = 3), and staff (n = 10) at 3 US hospitals that operate CRPs. Patients and families were eligible for participation if they experienced a CRP, spoke English, and could no longer file a malpractice claim because they had accepted a settlement or the statute of limitations had expired. The CRP administrators identified hospital and insurer staff who had been involved in a CRP event and had a close relationship with the injured patient and/or family. They identified patients and families by applying the inclusion criteria to their CRP databases. Of 66 possible participants, 40 interviews (61%) were completed, including 30 of 50 invited patients and families (60%) and 10 of 16 invited staff (63%). Main Outcomes and Measures: Patients' reported satisfaction with disclosure and reconciliation efforts made by hospitals. Results: A total of 40 participants completed interviews (15 men and 25 women; mean [range] age, 46 [18-67] years). Among the 30 patients and family members interviewed, 27 patients experienced injuries attributed to error and received compensation. The CRP experience was positive overall for 18 of the 30 patients and family members, and 18 patients continued to receive care at the hospital. Satisfaction was highest when communications were empathetic and nonadversarial, including compensation negotiations. Patients and families expressed a strong need to be heard and expected the attending physician to listen without interrupting during conversations about the event. Thirty-five of the 40 respondents believed that including plaintiffs' attorneys in these discussions was helpful. Sixteen of the 30 patients and family members deemed their compensation to be adequate but 17 reported that the offer was not sufficiently proactive. Patients and families strongly desired to know what the hospital did to prevent recurrences of the event, but 24 of 30 reported receiving no information about safety improvement efforts. Conclusions and Relevance: As hospitals strive to provide more patient-centered care, opportunities exist to improve institutional responses to injuries and promote reconciliation.
[Mh] Termos MeSH primário: Comunicação
Família/psicologia
Hospitais
Doença Iatrogênica
Segurança do Paciente
Assistência Centrada no Paciente/organização & administração
Pacientes/psicologia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Compensação e Reparação
Feminino
Seres Humanos
Entrevistas como Assunto
Masculino
Meia-Idade
Negociação
Avaliação de Processos e Resultados (Cuidados de Saúde)
Gestão de Riscos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171113
[Lr] Data última revisão:
171113
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171021
[St] Status:MEDLINE
[do] DOI:10.1001/jamainternmed.2017.4002


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[PMID]:29049120
[Au] Autor:Abrecht CR; Brovman EY; Greenberg P; Song E; Rathmell JP; Urman RD
[Ad] Endereço:From the *Department of Anesthesia and Perioperative Care, Division of Pain Medicine, University of California San Francisco, San Francisco, California; †Department of Anesthesiology, Perioperative, and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts; ‡Controlled Risk Insurance Company (CRICO) Strategies, Boston, Massachusetts; and §Harvard Medical School, Boston, Massachusetts.
[Ti] Título:A Contemporary Medicolegal Analysis of Outpatient Medication Management in Chronic Pain.
[So] Source:Anesth Analg;125(5):1761-1768, 2017 Nov.
[Is] ISSN:1526-7598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Opioids are frequently used in chronic pain management but are associated with significant morbidity and mortality in some patient populations. An important avenue for identifying complications-including serious or rare complications-is the study of closed malpractice claims. The present study is intended to complement the existing closed claims literature by drawing on claims from a more recent timeframe through a partnership with a large malpractice carrier, the Controlled Risk Insurance Company (CRICO). The goal of this study was to identify patient medical comorbidities and aberrant drug behaviors, as well as prescriber practices associated with patient injury and malpractice claims. Another objective was to identify claims most likely to result in payments and use this information to propose a strategy for reducing medicolegal risk. METHODS: The CRICO Strategies Comparative Benchmarking System is a database of claims drawing from >350,000 malpractice claims from Harvard-affiliated institutions and >400 other academic and community institutions across the United States. This database was queried for closed claims from January 1, 2009, to December 31, 2013, and identified 37 cases concerning noninterventional, outpatient chronic pain management. Each file consisted of a narrative summary, including expert witness testimony, as well as coded fields for patient demographics, medical comorbidities, the alleged damaging event, the alleged injurious outcome, the total financial amount incurred, and more. We performed an analysis using these claim files. RESULTS: The mean patient age was 43.5 years, with men representing 59.5% of cases. Payments were made in 27% of cases, with a median payment of $72,500 and a range of $7500-$687,500. The majority of cases related to degenerative joint disease of the spine and failed back surgery syndrome; no patients in this series received treatment of malignant pain. Approximately half (49%) of cases involved a patient death. The use of long-acting opioids and medical conditions affecting the cardiac and pulmonary systems were more closely associated with death than with other outcomes. The nonpain medical conditions present in this analysis included obesity, obstructive sleep apnea, chronic obstructive pulmonary disease, hypertension, and coronary artery disease. Other claims ranged from alleged addiction to opioids from improper prescribing to alleged abandonment with withdrawal of care. The CRICO analysis suggested that patient behavior contributed to over half of these claims, whereas deficits in clinical judgment contributed to approximately 40% of the claims filed. CONCLUSIONS: Claims related to outpatient medication management in pain medicine are multifactorial, stemming from deficits in clinical judgment by physicians, noncooperation in care by patients, and poor clinical documentation. Minimization of both legal risk and patient harm can be achieved by carefully selecting patients for chronic opioid therapy and documenting compliance and improvement with the treatment plan. Medical comorbidities such as obstructive sleep apnea and the use of long-acting opioids may be particularly dangerous. Continuing physician education on the safest and most effective approaches to manage these medications in everyday practice will lead to both improved legal security and patient safety.
[Mh] Termos MeSH primário: Assistência Ambulatorial/legislação & jurisprudência
Analgésicos Opioides/efeitos adversos
Dor Crônica/prevenção & controle
Imperícia/legislação & jurisprudência
Erros Médicos/legislação & jurisprudência
Clínicas de Dor/legislação & jurisprudência
Padrões de Prática Médica/legislação & jurisprudência
Avaliação de Processos (Cuidados de Saúde)/legislação & jurisprudência
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Assistência Ambulatorial/economia
Analgésicos Opioides/administração & dosagem
Causas de Morte
Dor Crônica/diagnóstico
Comorbidade
Compensação e Reparação/legislação & jurisprudência
Bases de Dados Factuais
Feminino
Seres Humanos
Seguro de Responsabilidade Civil/legislação & jurisprudência
Responsabilidade Legal
Masculino
Imperícia/economia
Erros Médicos/economia
Erros Médicos/mortalidade
Meia-Idade
Clínicas de Dor/economia
Medição da Dor
Segurança do Paciente
Padrões de Prática Médica/economia
Avaliação de Processos (Cuidados de Saúde)/economia
Medição de Risco
Fatores de Risco
Resultado do Tratamento
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Analgesics, Opioid)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171020
[St] Status:MEDLINE
[do] DOI:10.1213/ANE.0000000000002499


  6 / 2703 MEDLINE  
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[PMID]:28982884
[Au] Autor:Desserud KF; Bukholm I; Søreide JA
[Ad] Endereço:Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway.
[Ti] Título:Compensation Claims for Sub-substandard Care of Patients with Gastroentero-pancreatic Neuroendocrine Tumors: A Nationwide Descriptive Study of Cases Between 2005-2016 in Norway.
[So] Source:Anticancer Res;37(10):5667-5671, 2017 10.
[Is] ISSN:1791-7530
[Cp] País de publicação:Greece
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Management of patients with neuroendocrine tumors of the gastrointestinal tract or pancreas (GEP-NENs) poses diagnostic and therapeutic challenges. This study described the medico-legal claims reported to a national governmental system that oversees compensation to patients with GEP-NENs Materials and Methods: An electronic search of the Norwegian System of Compensation to Patients database was performed to identify claims evaluated between 2005-2016. The clinical information and the medico-legal evaluation were reviewed. RESULTS: We identified seven patients, five women and two men, with a median age of 57 (range=47-73) years. Delayed diagnosis (median diagnostic delay of 18 (range=6-48) months) was the main cause for claims in six out of the seven patients). Four patients received financial compensation based on the claim judgement. CONCLUSION: This review of claims that were evaluated by the Norwegian System of Compensation to Patients showed that a timely diagnosis of GEP-NENs remains a clinical challenge.
[Mh] Termos MeSH primário: Carcinoma Neuroendócrino/economia
Carcinoma Neuroendócrino/terapia
Compensação e Reparação
Neoplasias Gastrointestinais/economia
Neoplasias Gastrointestinais/terapia
Erros Médicos/economia
Oncologia/economia
Neoplasias Pancreáticas/economia
Neoplasias Pancreáticas/terapia
[Mh] Termos MeSH secundário: Demandas Administrativas em Assistência à Saúde
Idoso
Carcinoma Neuroendócrino/patologia
Compensação e Reparação/legislação & jurisprudência
Bases de Dados Factuais
Diagnóstico Tardio/economia
Erros de Diagnóstico/economia
Feminino
Neoplasias Gastrointestinais/patologia
Seres Humanos
Responsabilidade Legal/economia
Masculino
Erros Médicos/legislação & jurisprudência
Oncologia/legislação & jurisprudência
Erros de Medicação
Meia-Idade
Estadiamento de Neoplasias
Noruega
Neoplasias Pancreáticas/patologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171007
[St] Status:MEDLINE


  7 / 2703 MEDLINE  
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[PMID]:28792819
[Au] Autor:Tingle J
[Ad] Endereço:Reader in Health Law at Nottingham Trent University.
[Ti] Título:Clinical negligence litigation: balancing the interests.
[So] Source:Br J Nurs;26(15):898-899, 2017 Aug 10.
[Is] ISSN:0966-0461
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:John Tingle, Reader in Health Law at Nottingham Trent University, discusses a recent report by the Medical Protection Society on the need to control the costs of clinical negligence litigation.
[Mh] Termos MeSH primário: Imperícia/legislação & jurisprudência
Enfermeiras e Enfermeiros
Medicina Estatal/legislação & jurisprudência
[Mh] Termos MeSH secundário: Compensação e Reparação/legislação & jurisprudência
Seres Humanos
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:N
[Da] Data de entrada para processamento:170810
[St] Status:MEDLINE
[do] DOI:10.12968/bjon.2017.26.15.898


  8 / 2703 MEDLINE  
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[PMID]:28622485
[Au] Autor:Connelly LB
[Ti] Título:The Nature of Whiplash in a Compensable Environment: Injury, Disability, Rehabilitation, and Compensation Systems.
[So] Source:J Orthop Sports Phys Ther;47(7):503-508, 2017 Jul.
[Is] ISSN:1938-1344
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Synopsis Whiplash is a compensable injury in many jurisdictions, but there is considerable heterogeneity in the compensation arrangements that apply across jurisdictions, even within some countries. These compensation schemes have, however, been subject to a common set of interrelated concerns, chiefly concerning the incentives, behaviors, and outcomes that may arise when financial compensation for injuries is available to injured parties. This article provides a nontechnical overview of some of those concerns through the lens of economics: principally, insurance economics and health economics, including related subsets such as information economics and agency theory, as well as economics and the law. It notes that because it is generally infeasible to randomize the treatment (ie, compensation) via trials, analyses of observational data are necessary to discover more about the relationship between compensation and health outcomes. This poses the analytical challenge of discovering causal connections between phenomena from nonrandomized data sets. The present article calls for further research that would enable convincing causal interpretations of such relationships via the careful analysis of rich observational data sets using modern econometric methods. J Orthop Sports Phys Ther 2017;47(7):503-508. Epub 16 Jun 2017. doi:10.2519/jospt.2017.7533.
[Mh] Termos MeSH primário: Acidentes de Trânsito/economia
Pessoas com Deficiência/reabilitação
Seguro Saúde
Traumatismos em Chicotada/economia
Traumatismos em Chicotada/reabilitação
[Mh] Termos MeSH secundário: Compensação e Reparação/ética
Compensação e Reparação/legislação & jurisprudência
Avaliação da Deficiência
Pessoas com Deficiência/psicologia
Seres Humanos
Seguro Saúde/ética
Motivação
Traumatismos em Chicotada/diagnóstico
Traumatismos em Chicotada/psicologia
Indenização aos Trabalhadores
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170801
[Lr] Data última revisão:
170801
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170617
[St] Status:MEDLINE
[do] DOI:10.2519/jospt.2017.7533


  9 / 2703 MEDLINE  
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[PMID]:28582459
[Au] Autor:Ioannou LJ; Cameron PA; Gibson SJ; Gabbe BJ; Ponsford J; Jennings PA; Arnold CA; Gwini SM; Georgiou-Karistianis N; Giummarra MJ
[Ad] Endereço:School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences, Clayton, Victoria, Australia.
[Ti] Título:Traumatic injury and perceived injustice: Fault attributions matter in a "no-fault" compensation state.
[So] Source:PLoS One;12(6):e0178894, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Traumatic injury can lead to loss, suffering and feelings of injustice. Previous research has shown that perceived injustice is associated with poorer physical and mental wellbeing in persons with chronic pain. This study aimed to identify the relative association between injury, compensation and pain-related characteristics and perceived injustice 12-months after traumatic injury. METHODS: 433 participants were recruited from the Victorian Orthopedic Trauma Outcomes Registry and Victorian State Trauma Registry, and completed questionnaires at 12-14 months after injury as part of an observational cohort study. Using hierarchical linear regression we examined the relationships between baseline demographics (sex, age, education, comorbidities), injury (injury severity, hospital length of stay), compensation (compensation status, fault, lawyer involvement), and health outcomes (SF-12) and perceived injustice. We then examined how much additional variance in perceived injustice was related to worse pain severity, interference, self-efficacy, catastrophizing, kinesiophobia or disability. RESULTS: Only a small portion of variance in perceived injustice was related to baseline demographics (especially education level), and injury severity. Attribution of fault to another, consulting a lawyer, health-related quality of life, disability and the severity of pain-related cognitions explained the majority of variance in perceived injustice. While univariate analyses showed that compensable injury led to higher perceptions of injustice, this did not remain significant when adjusting for all other factors, including fault attribution and consulting a lawyer. CONCLUSIONS: In addition to the "justice" aspects of traumatic injury, the health impacts of injury, emotional distress related to pain (catastrophizing), and the perceived impact of pain on activity (pain self-efficacy), had stronger associations with perceptions of injustice than either injury or pain severity. To attenuate the likelihood of poor recovery from injury, clinical interventions that support restoration of health-related quality of life, and adjustment to the impacts of trauma are needed.
[Mh] Termos MeSH primário: Adaptação Psicológica
Dor/psicologia
Qualidade de Vida/psicologia
Sistema de Registros
Percepção Social
Ferimentos e Lesões/psicologia
[Mh] Termos MeSH secundário: Adulto
Catastrofização/fisiopatologia
Catastrofização/psicologia
Estudos de Coortes
Compensação e Reparação
Avaliação da Deficiência
Pessoas com Deficiência/psicologia
Feminino
Seres Humanos
Tempo de Internação
Modelos Lineares
Masculino
Meia-Idade
Dor/fisiopatologia
Medição da Dor
Inquéritos e Questionários
Índices de Gravidade do Trauma
Vitória
Ferimentos e Lesões/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170919
[Lr] Data última revisão:
170919
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170606
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0178894


  10 / 2703 MEDLINE  
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[PMID]:28549980
[Au] Autor:Glaser LM; Alvi FA; Milad MP
[Ad] Endereço:Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, IL. Electronic address: l-matthews@northwestern.edu.
[Ti] Título:Trends in malpractice claims for obstetric and gynecologic procedures, 2005 through 2014.
[So] Source:Am J Obstet Gynecol;217(3):340.e1-340.e6, 2017 Sep.
[Is] ISSN:1097-6868
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Interest in medical malpractice and areas of medicolegal vulnerability for practicing obstetricians and gynecologists has grown substantially, and many providers report changing surgical practice out of fear of litigation. Furthermore, education on medical malpractice and risk management is lacking for obstetrics and gynecology trainees. Recent obstetric and gynecologic malpractice claims data are lacking. We report on recent trends in malpractice claims for obstetrics and gynecology procedures, and compare these trends to those of other medical specialties. OBJECTIVE: We sought to evaluate recent trends in malpractice claims for obstetrics and gynecology procedures and compare these to other medical specialties. STUDY DESIGN: A search was performed on all medicolegal claims data for obstetrics and gynecology procedures from Jan. 1, 2005, through Dec. 31, 2014, using the Physician Insurers' Association of America data-sharing project, which was created to identify medical professional liability trends. Data from 20 insurance carriers were reviewed based on a search using International Classification of Diseases, Ninth Revision codes and unique database-specific codes. RESULTS: Of the 10,915 total claims closed from 2005 through 2014, the majority (59.5%) were dropped, withdrawn, or dismissed. The average indemnity of the remaining paid claims (31.1%) was $423,250. The most frequently litigated procedure was operative procedures on the uterus; 27.8% of cases were paid with an average indemnity of $279,384. The procedure associated with the highest proportion of paid claims was vacuum extraction. The average indemnity for paid obstetrics and gynecology procedural claims was 27% higher than that for all medical specialties combined. Obstetrics and gynecology procedural claims had the second highest average indemnity payment and the fifth highest paid-to-closed ratio of all medical specialties. CONCLUSION: Litigation claims for obstetrics and gynecology procedures have higher average indemnity payments and higher paid-to-closed ratios than most other medical specialties. Claims most frequently relate to gynecologic surgery, but obstetric procedures are more expensive. Possible factors may include procedural experience and unique perioperative complications. We encourage efforts addressing procedures, litigation, and quality interventions to improve outcomes, mitigate risk, and potentially lower indemnity payments.
[Mh] Termos MeSH primário: Compensação e Reparação
Procedimentos Cirúrgicos em Ginecologia/legislação & jurisprudência
Imperícia/legislação & jurisprudência
Imperícia/tendências
Procedimentos Cirúrgicos Obstétricos/legislação & jurisprudência
[Mh] Termos MeSH secundário: Feminino
Seres Humanos
Gravidez
Estudos Retrospectivos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170918
[Lr] Data última revisão:
170918
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170528
[St] Status:MEDLINE



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