Rae Matthew, Barreto Rocha Daniela F, Hayes Daniel S, Haak Michael, Maniar Hemil, Grandizio Louis C
Geisinger Commonwealth School of Medicine, Geisinger Musculoskeletal Institute, Danville, PA.
Spine (Phila Pa 1976). 2022 Jul 15;47(14):E521-E526. doi: 10.1097/BRS.0000000000004272. Epub 2021 Nov 2.
Case-control study.
To analyze patient complaints, potential risk, and malpractice events involving orthopedic spine surgeons over a 10-year period.
Unsolicited patient complaints may be associated with risk management and malpractice events.
We analyzed patient complaint, potential risk event, and malpractice event data for six orthopedic spine surgeons over a 10-year period. Patient complaints were analyzed and classified according to the Patient Complaint Analysis System. Baseline demographics were recorded for patients with complaints as well as the surgeons. A control group consisting of all patients seen by the six surgeons during the study period was created to identify patient and physician risk factors for formal patient complaints. Event rates (for complaints, risk, and malpractice events) were calculated by dividing the number of events by the total number of unique patients seen.
There were 214 complaint designations among 202 patients with formal complaints, resulting in a complaint rate of 0.79%. Patients were most likely to complain about access and availability (35%) followed by care and treatment (32%). Of the 68 complaints regarding care and treatment, 34 were related to dissatisfaction with surgical outcome. Complications were identified in 26/34 cases. The malpractice event rate ranged from 0.06% to 0.65%. Patients who had surgery ( P < 0.0001) or a mental, behavioral, or neurodevelopmental disorder ( P = 0.0004) were more likely to file complaints compared with the control group.
While infrequent, patient complaints against orthopedic spine surgeons are most related to access and availability. The rate of malpractice events varies widely between surgeons.
病例对照研究。
分析10年间涉及骨科脊柱外科医生的患者投诉、潜在风险和医疗事故事件。
主动提出的患者投诉可能与风险管理和医疗事故事件相关。
我们分析了10年间6位骨科脊柱外科医生的患者投诉、潜在风险事件和医疗事故事件数据。根据患者投诉分析系统对患者投诉进行分析和分类。记录了有投诉的患者以及外科医生的基线人口统计学数据。创建了一个由6位外科医生在研究期间诊治的所有患者组成的对照组，以确定导致正式患者投诉的患者和医生风险因素。事件发生率（投诉、风险和医疗事故事件）通过将事件数量除以所诊治的独特患者总数来计算。
202例有正式投诉的患者中有214项投诉认定，投诉率为0.79%。患者最常投诉的是就医机会和可及性（35%），其次是护理和治疗（32%）。在68项关于护理和治疗的投诉中，34项与对手术结果的不满有关。34例中有26例发现了并发症。医疗事故事件发生率在0.06%至0.65%之间。与对照组相比，接受过手术的患者（P<0.0001）或患有精神、行为或神经发育障碍的患者（P = 0.0004）更有可能提出投诉。
虽然针对骨科脊柱外科医生的患者投诉并不常见，但大多与就医机会和可及性有关。外科医生之间的医疗事故事件发生率差异很大。
