Steinø Per, Jørgensen Cecilie B, Christoffersen Jens Krogh
Department of Psychiatry, Holstebro Regional Hospital.
Dan Med J. 2013 Aug;60(8):A4621.
Since 1992 the Danish Patient Insurance Association (DPIA) has been receiving claims from patients who had suffered an injury during examination or treatment in Danish healthcare. We have presently collected more than 85,000 patient cases in our database, which we make accessible to research that can promote patient safety. We now want to draw attention to conditions that mainly apply to patients with mental disorders.
By searching the DPIA database over the past 15 years, we identified 1,278 patients with mental disorders. These patients were studied with respect to whether they had been treated within the psychiatric specialty or in a somatic specialty. During the study period, there was a change of opinion in the legal system after the Supreme Court ruled that surveillance of a psychiatric patient during admission, e.g. as anti-suicide precaution, should also be considered part of the treatment.
Of the registered claims, 742 had received specialised psychiatric treatment for their mental disorders, and 536 had been treated in one of the somatic specialties. Of the 1,278 patients, 16% had their claims accepted. A marked difference was found in the acceptance rate of claims between these two groups: in psychiatry, 13% of the claims were accepted, whereas in the somatic specialties, the acceptance rate was 21%. Both of these numbers are well below the usual DPIA acceptance rate, which is 36% (p = 0.001). During the study period, there was a change in the Danish legal system after the Danish Supreme Court ruled that surveillance of a psychiatric patient during admission, e.g. as an anti-suicide precaution, should be considered part of the treatment.
The low acceptance rate for claims made by patients with mental disorders concerning treatment or examination may, in part, be due to the lodging of unqualified claims, but other causes may also have contributed to this. Psychiatric patients who are treated for somatic disease should receive special attention to avoid treatment-related injuries.
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自1992年以来，丹麦患者保险协会（DPIA）一直在受理患者提出的在丹麦医疗保健机构接受检查或治疗期间受伤的索赔。目前，我们的数据库中已收集了超过85000个患者案例，并向能够促进患者安全的研究开放。我们现在想提请注意主要适用于精神障碍患者的情况。
通过检索DPIA过去15年的数据库，我们确定了1278名精神障碍患者。对这些患者是否在精神科专科或躯体专科接受治疗进行了研究。在研究期间，最高法院裁定住院期间对精神科患者的监护（例如作为预防自杀措施）也应被视为治疗的一部分，此后法律制度发生了意见变化。
在登记的索赔中，742名患者因其精神障碍接受了专门的精神科治疗，536名患者在其中一个躯体专科接受了治疗。在这1278名患者中，16%的索赔获得了受理。这两组之间的索赔受理率存在显著差异：在精神科，13%的索赔获得受理，而在躯体专科，受理率为21%。这两个数字均远低于DPIA通常的受理率36%（p = 0.001）。在研究期间，丹麦最高法院裁定住院期间对精神科患者的监护（例如作为预防自杀措施）应被视为治疗的一部分，此后丹麦法律制度发生了变化。
精神障碍患者关于治疗或检查的索赔受理率较低，部分原因可能是提出了不合格的索赔，但其他原因也可能对此有所影响。因躯体疾病接受治疗的精神科患者应受到特别关注，以避免与治疗相关的伤害。
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