From the Geisinger Commonwealth School of Medicine, Geisinger Musculoskeletal Institute, Danville, PA.
J Am Acad Orthop Surg. 2021 Aug 1;29(15):659-665. doi: 10.5435/JAAOS-D-21-00073.
Our purpose was to define and categorize patient complaints within a hand surgery practice over a 10-year period. In addition, we aimed to define surgeon and patient factors associated with formal complaints.
All patients who filed a complaint with our institution's patient advocacy service against six hand surgeons in an academic practice over a 10-year period were recorded and categorized using the Patient Complaint Analysis System. A control group consisting of all patients seen by the surgeons during the study period was created. Demographic differences between the complaint and control groups were analyzed, as were complaint rates between surgeons. We obtained the number of malpractice events involving each of the surgeons.
During the 10-year study period, 73 of 36,010 unique patients seen (0.20%) filed a complaint. Care and treatment category comprised the highest percentage of complaint designations (30%), followed by access and availability (23%). Forty-three patients (59%) who filed complaints were treated surgically. Patients with a complaint had a significantly higher percentage of mental, behavioral, or neurodevelopmental disorders compared with controls (55% versus 42%, P = 0.03). The complaint rate (total complaints/total new patients seen) ranged between 0.09% and 0.29% for the six surgeons, and these results were not statistically significant.
Within an academic hand and upper extremity surgery practice, the rate of patient complaints is 0.20% or approximately one complaint for every 500 new patients seen. Most patient complaints are categorized within the care and treatment domain. Underlying mental health conditions are associated with more frequent complaints. Communication issues appear to represent a modifiable area that hand surgeons can improve to help mitigate potential complaints. Understanding both the frequency and types of patient complaints may allow hand surgeons to recognize areas for improvement and avoid potential exposure to malpractice litigation.
Prognostic level III (case-control).
我们的目的是在 10 年的时间内定义和分类手外科实践中的患者投诉，并确定与正式投诉相关的外科医生和患者因素。
记录并使用患者投诉分析系统对手术室在 10 年期间收到的对 6 位手外科医生的所有患者投诉进行分类。创建了一个由研究期间所有接受外科医生治疗的患者组成的对照组。分析了投诉组和对照组之间的人口统计学差异，以及外科医生之间的投诉率。我们获得了每位外科医生涉及的医疗事故事件数量。
在 10 年的研究期间，36010 名就诊的患者中有 73 名（0.20%）提出了投诉。治疗和护理类投诉占比最高（30%），其次是就诊途径和便利性（23%）。43 名（59%）提出投诉的患者接受了手术治疗。与对照组相比，投诉患者的精神、行为或神经发育障碍的比例明显更高（55%比 42%，P=0.03）。6 位外科医生的投诉率（总投诉/新就诊患者总数）在 0.09%至 0.29%之间，差异无统计学意义。
在学术性手部和上肢外科实践中，患者投诉率为 0.20%，即每 500 名新就诊患者中约有 1 名投诉。大多数患者投诉被归类于治疗护理领域。潜在的心理健康状况与更频繁的投诉相关。沟通问题似乎代表了一个可改善的领域，手部外科医生可以改进以帮助减少潜在的投诉。了解患者投诉的频率和类型可以使手部外科医生认识到需要改进的领域，并避免潜在的医疗事故诉讼风险。
预后 III 级（病例对照）。
