Kuosmanen L, Kaltiala-Heino R, Suominen S, Kärkkäinen J, Hätönen H, Ranta S, Välimäki M
University of Turku, Department of Nursing Science, Turku, Finland.
J Med Ethics. 2008 Nov;34(11):788-92. doi: 10.1136/jme.2008.024463.
Today, monitoring of patient complaints in healthcare services is being used as a tool for quality assurance systems and in the future development of services. This nationwide register study describes the number of all complaints processed, number of complaints between different state provinces, healthcare services and healthcare professionals, and outcomes of complaints in Finland during the period 2000-2004. All complaints processed at the State Provincial Offices and the National Authority for Medicolegal Affairs were analysed by statistical methods. Complaints about mental healthcare were explored in greater detail. The analysis showed that the number of patient complaints increased considerably during the study period. There were changes in the number of complaints between study years in different provinces. Out of different healthcare services, an especially marked increase was seen in private healthcare. Nearly all complaints were lodged against physicians, and over half of the complaints were made because of medical error. In mental health care, patients more often complained about unsatisfactory certificates and statements and the use of compulsory hospital care. An analysis of the outcomes revealed that in mental health care complaints more seldom led to consequences. The results need to be utilised when planning interventions for advanced supervision, prevention of adverse events and patient safety in healthcare, and especially in mental health care. From the patients' perspective, it is important to create a culture where most problem situations are handled where the treatment was provided, thus avoiding a complex complaints process.
如今,医疗服务中患者投诉的监测正被用作质量保证体系的一项工具以及服务未来发展的依据。这项全国性登记研究描述了2000年至2004年期间芬兰处理的所有投诉数量、不同省份、医疗服务机构和医疗专业人员之间的投诉数量以及投诉结果。对在省级办公室和国家法医学事务管理局处理的所有投诉进行了统计分析。对精神卫生保健方面的投诉进行了更详细的探讨。分析表明,在研究期间患者投诉数量大幅增加。不同省份在各研究年份的投诉数量有所变化。在不同的医疗服务中,私立医疗服务的投诉数量尤其显著增加。几乎所有投诉都是针对医生提出的,超过一半的投诉是由于医疗差错。在精神卫生保健方面,患者更多地抱怨证书和声明不尽人意以及强制住院治疗的使用情况。对投诉结果的分析显示,在精神卫生保健方面,投诉很少产生后果。在规划针对医疗保健尤其是精神卫生保健的高级监督、不良事件预防和患者安全的干预措施时,需要利用这些结果。从患者的角度来看,营造一种文化很重要,即在提供治疗的地方处理大多数问题情况,从而避免复杂的投诉过程。