Vehkalahti Miira M, Swanljung Outi
a Department of Oral and Maxillofacial Diseases, Faculty of Medicine , University of Helsinki , Helsinki , Finland.
b Department of Oral Health Care , The Patient Insurance Centre , Helsinki , Finland.
Acta Odontol Scand. 2017 Apr;75(3):155-160. doi: 10.1080/00016357.2016.1272000. Epub 2017 Jan 4.
We analyzed operator-related differences in endodontic malpractice claims in Finland.
Data comprised the endodontic malpractice claims handled at the Patient Insurance Centre (PIC) in 2002-2006 and 2011-2013. Two dental advisors at the PIC scrutinized the original documents of the cases (n = 1271). The case-related information included patient's age and gender, type of tooth, presence of radiographs, and methods of instrumentation and apex location. As injuries, we recorded broken instrument, perforation, injuries due to root canal irrigants/medicaments, and miscellaneous injuries. We categorized the injuries according to the PIC decisions as avoidable, unavoidable, or no injury. Operator-related information included dentist's age, gender, specialization, and service sector. We assessed level of patient documentation as adequate, moderate, or poor. Chi-squared tests, t-tests, and logistic regression modelling served in statistical analyses.
Patients' mean age was 44.7 (range 8-85) years, and 71% were women. The private sector constituted 54% of claim cases. Younger patients, female dentists, and general practitioners predominated in the public sector. We found no sector differences in patients' gender, dentists' age, or type of injured tooth. PIC advisors confirmed no injury in 24% of claim cases; the advisors considered 65% of injury cases (n = 970) as avoidable and 35% as unavoidable. We found no operator-related differences in these figures. Working methods differed by operator's age and gender. Adequate patient documentation predominated in the public sector and among female, younger, or specialized dentists.
Operator-related factors had no impact on endodontic malpractice claims.
我们分析了芬兰牙髓治疗医疗事故索赔中与操作人员相关的差异。
数据包括2002 - 2006年及2011 - 2013年在患者保险中心（PIC）处理的牙髓治疗医疗事故索赔。PIC的两名牙科顾问仔细审查了这些病例的原始文件（n = 1271）。与病例相关的信息包括患者的年龄和性别、牙齿类型、X光片的存在情况、器械操作方法和根尖位置。作为损伤情况，我们记录了器械折断、穿孔、根管冲洗液/药物导致的损伤以及其他损伤。我们根据PIC的决定将损伤分类为可避免、不可避免或无损伤。与操作人员相关的信息包括牙医的年龄、性别、专业和服务部门。我们将患者记录水平评估为充分、中等或较差。采用卡方检验、t检验和逻辑回归模型进行统计分析。
患者的平均年龄为44.7岁（范围8 - 85岁），71%为女性。私营部门占索赔病例的54%。年轻患者、女牙医和全科医生在公共部门占主导。我们发现患者性别、牙医年龄或受伤牙齿类型在不同部门之间没有差异。PIC顾问确认24%的索赔病例无损伤；顾问认为65%的损伤病例（n = 970）是可避免的，35%是不可避免的。我们在这些数据中未发现与操作人员相关的差异。工作方法因操作人员的年龄和性别而异。充分的患者记录在公共部门以及女性、年轻或专科牙医中占主导。
与操作人员相关的因素对牙髓治疗医疗事故索赔没有影响。
