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2005 - 2014年挪威北部的手腕医疗事故索赔。可吸取的教训。

Wrist malpractice claims in Northern Norway 2005-2014. Lessons to be learned.

作者信息

Norum Jan, Balteskard Lise, Thomsen Mette Willumstad, Kvernmo Hebe Desiree

机构信息

a Department of Clinical Medicine, Medical Imaging Research Group, Faculty of Health Sciences , UiT- The Arctic University of Norway , Tromsø , Norway.

b Department of Surgery , Finnmark hospital trust , Hammerfest , Norway.

出版信息

Int J Circumpolar Health. 2018 Dec;77(1):1483690. doi: 10.1080/22423982.2018.1483690.

Abstract

Rough weather conditions in the subarctic areas of Norway may influence on the risk of wrist fracture. We implemented data from the Norwegian System of Patient Injury Compensation (NPE). All claims due to wrist surgery, performed at the public hospitals in Northern Norway, during 2005-2014 were analyzed. We employed the ICD-10 classification codes S52.5 (fracture of distal end of radius) and S52.6 (fracture of distal end of radius and ulna). Treatment was defined by NCSP codes. 84 patients (0.3%) complained. Females complained four times more often than males did (P = 0.005) and received five times more frequently a compensation (P < 0.001). NPE accepted 34 claims (40%) for injury compensation (0.1% of patients). The percentage of claims accepted for compensation decreased from 48% to 30% during study period, probably due to delay in filling claims. The main causes of complains were pain, reduced range of motion, malfunction and weakness (35/84). The main causes of compensation were "operative treatment should have been performed" (14/34) and "wrong operative method applied" (13/34). The mean amount per compensation was €14,927 (€0-€52,995). Stonger focus on quality of care, updated guidelines and shared decission-making may reduce the number og complains and compensations.

摘要

挪威亚北极地区恶劣的天气条件可能会影响手腕骨折的风险。我们采用了挪威患者伤害赔偿系统(NPE)的数据。对2005年至2014年期间在挪威北部公立医院进行的所有因手腕手术引发的索赔进行了分析。我们使用了国际疾病分类第十版(ICD - 10)编码S52.5(桡骨远端骨折)和S52.6(桡骨和尺骨远端骨折)。治疗情况由挪威国家患者安全计划(NCSP)编码确定。84名患者(0.3%)提出了投诉。女性投诉的频率是男性的四倍(P = 0.005),获得赔偿的频率是男性的五倍(P < 0.001)。NPE接受了34项伤害赔偿索赔(占患者的0.1%)。在研究期间,获得赔偿的索赔百分比从48%降至30%,可能是由于索赔提交延迟。投诉的主要原因是疼痛、活动范围减小、功能障碍和虚弱(35/84)。赔偿的主要原因是“本应进行手术治疗”(14/34)和“采用了错误的手术方法”(13/34)。每项赔偿的平均金额为14,927欧元(0欧元至52,995欧元)。更加关注医疗质量、更新指南和共同决策可能会减少投诉和赔偿的数量。

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