Mello Michelle M, Kachalia Allen, Studdert David M
Harvard School of Public Health, USA.
Issue Brief (Commonw Fund). 2011 Jul;14:1-18.
The United States requires patients injured by medical negligence to seek compensation through lawsuits, an approach that has drawbacks related to fairness, cost, and impact on medical care. Several countries, including New Zealand, Sweden, and Denmark, have replaced litigation with administrative compensation systems for patients who experience an avoidable medical injury. Sometimes called "no-fault" systems, such schemes enable patients to file claims for compensation without using an attorney. A governmental or private adjudicating organization uses neutral medical experts to evaluate claims of injury and does not require patients to prove that health care providers were negligent in order to receive compensation. Information from claims is used to analyze opportunities for patient safety improvement. The systems have successfully limited liability costs while improving injured patients' access to compensation. American policymakers may find many of the elements of these countries' systems to be transferable to demonstration projects in the U.S.
美国要求因医疗过失而受伤的患者通过诉讼寻求赔偿，这种方式在公平性、成本以及对医疗护理的影响方面存在缺陷。包括新西兰、瑞典和丹麦在内的几个国家，已针对遭受可避免医疗伤害的患者，用行政赔偿制度取代了诉讼。这类方案有时被称为“无过错”制度，能让患者无需聘请律师就可提出赔偿申请。一个政府或私人裁决机构会利用中立的医学专家来评估伤害索赔，并且在患者获得赔偿时，不要求他们证明医疗服务提供者存在过失。索赔信息会用于分析改善患者安全的机会。这些制度在成功限制责任成本的同时，还改善了受伤患者获得赔偿的途径。美国政策制定者可能会发现，这些国家制度的许多要素可移植到美国的示范项目中。
