Specialty Registrar in Public Health, Public Health Suffolk, Suffolk County Council, Endeavour House, 8 Russell Road, Ipswich, Suffolk, England, IP1 2BX.
Public Health Suffolk, Suffolk County Council, Endeavour House, 8 Russell Road, Ipswich, Suffolk, England, IP1 2BX.
Int J Qual Health Care. 2021 Feb 20;33(1). doi: 10.1093/intqhc/mzaa141.
Identify organizational factors associated with high clinical litigation rates among acute National Health Service (NHS) trusts in England.
Cross-sectional analysis using routine data.
NHS trusts in England.
A total of 235 NHS trusts used the NHS Clinical Negligence Scheme in 2016-17. Ninety-seven trusts (41.3%) with no maternity services, 2 (0.9%) providing specialized services and 3 (1.2%) without clinical negligence claims were excluded. Hence, the remaining 133 trusts (56.6%) were included.
INTERVENTION(S): None.
Rate of clinical litigation by trust per 100 000 occupied bed days.
The mean rate of clinical litigation was 25.4 per 100 000 occupied bed days. In univariable analyses, higher values of summary hospital-level mortality indictor, staff sickness, written complaints, patient safety incidents and being in the North of England led to increased clinical litigation rates. Conversely, higher patient admissions, NHS Staff Survey overall engagement score and occupied bed days led to decreased clinical litigation rates. In the multivariable model, factors associated with increased clinical litigation rates were as follows: summary mortality hospital-level indicator (SHMI) (0.9 increase in litigation rate per 0.05 increase in SHMI; P = 0.012); new written complaints (0.62 increase per 50 complaints higher; P < 0.001); located in the North of England compared to London (5.22 higher; P < 0.001). Conversely, a higher number of occupied bed days (-0.64 change per 50 000 days higher; P = 0.007) was associated with lower clinical litigation rates.
This study identified organizational factors associated with clinical litigation, which will be of interest to clinicians and the NHS. This research also highlights areas for further investigation.
确定与英格兰急性国民保健服务（NHS）信托机构高临床诉讼率相关的组织因素。
使用常规数据进行的横断面分析。
英格兰 NHS 信托机构。
共有 235 家 NHS 信托机构在 2016-17 年使用 NHS 临床疏忽计划。排除了 97 家（41.3%）没有产科服务的信托机构、2 家（0.9%）提供专业服务的信托机构和 3 家（1.2%）没有临床疏忽索赔的信托机构。因此，纳入了其余 133 家（56.6%）信托机构。
无。
每家信托机构每 100000 个占用床位的临床诉讼率。
临床诉讼的平均比率为每 100000 个占用床位 25.4 例。在单变量分析中，较高的医院级别综合死亡率指标、员工病假、书面投诉、患者安全事件和位于英格兰北部会导致临床诉讼率上升。相反，较高的患者入院率、NHS 员工调查整体参与度评分和占用床日数会导致临床诉讼率下降。在多变量模型中，与临床诉讼率增加相关的因素如下：医院级别综合死亡率指标（SHMI）（SHMI 每增加 0.05，诉讼率增加 0.9；P=0.012）；新的书面投诉（每增加 50 次投诉，增加 0.62；P<0.001）；与伦敦相比位于英格兰北部（增加 5.22；P<0.001）。相反，较高的占用床日数（每增加 50000 天，减少 0.64；P=0.007）与较低的临床诉讼率相关。
本研究确定了与临床诉讼相关的组织因素，这将引起临床医生和 NHS 的兴趣。本研究还突出了进一步调查的领域。
