Fanous R, Sabharwal S, Altaie A, Gupte C M, Reilly P
Department of Trauma Orthopaedics, St Mary's Hospital, Imperial College Healthcare NHS Trust , London, W2 1NY , UK.
Ann R Coll Surg Engl. 2017 Jan;99(1):17-21. doi: 10.1308/rcsann.2016.0277. Epub 2016 Sep 23.
We present a review evaluating all litigation claims relating to hip fractures made in a 10-year period between 2005 and 2015. Data was obtained from the NHS Litigation Authority through a freedom of information request. All claims relating to hip fractures were reviewed. During the period analysed, 216 claims were made, of which 148 were successful (69%). The total cost of settling these claims was in excess of £5 million. The introduction of a best-practice tariff by the Department of Health in 2010 was designed to improve the quality of care for hip fracture patients. This was followed by guidance from the National Institute for Health and Clinical Excellence in 2011 and the British Orthopaedic Association in 2012. We analysed claims submitted before and after these guidelines were introduced and no significant difference in the number of claims was noted. The most common cause for litigation was a delay in diagnosis, which accounted for 86 claims in total (40%). Despite the presence of these guidelines and targets, there has not been a significant reduction in the number of claims or an improvement in diagnostic accuracy. This may be due to an increasing level of litigation in the UK but we must also question whether we are indeed providing best-practice care to our hip fracture patients and whether these guidelines need further review.
我们发表了一篇综述，评估了2005年至2015年这10年间与髋部骨折相关的所有诉讼索赔。数据是通过信息自由请求从英国国家医疗服务诉讼局获取的。对所有与髋部骨折相关的索赔进行了审查。在分析的时间段内，共提出了216项索赔，其中148项成功（69%）。解决这些索赔的总成本超过500万英镑。2010年卫生部引入了最佳实践收费标准，旨在提高髋部骨折患者的护理质量。随后，2011年英国国家卫生与临床优化研究所和2012年英国骨科协会发布了相关指南。我们分析了这些指南发布前后提交的索赔，发现索赔数量没有显著差异。诉讼的最常见原因是诊断延误，总共占86项索赔（40%）。尽管有这些指南和目标，但索赔数量并未显著减少，诊断准确性也没有提高。这可能是由于英国诉讼水平的提高，但我们也必须质疑我们是否真的为髋部骨折患者提供了最佳实践护理，以及这些指南是否需要进一步审查。
