Lesta Law Firm, 45-316 Opole, Poland.
Department of Management and Logistics in Healthcare, Medical University of Lodz, 90-419 Lodz, Poland.
Int J Environ Res Public Health. 2022 Jun 28;19(13):7932. doi: 10.3390/ijerph19137932.
The globally increasing healthcare expenditures related to the need to treat the consequences of adverse events, as well as the number of claims filed by patients (or their families) and remuneration paid as their result mean that the interest in the subject of adverse event cost management is increasing. An increase in the number of cases concerning medical errors has also occurred in Poland in recent years. The newest statistics from the Ministry of Justice demonstrate that the courts are awarding increasingly higher amounts. The goal of this work was an attempt to approximate, based on our own experiences, the impact of adverse events on the expenditures of the healthcare system in Poland, including the costs of treatment of the consequences of such events, described by the authors as "secondary harm".
Based on the analysis of 100 cases for compensation for the occurrence of a medical event, an initial estimate of the costs of primary (initial) treatment, which resulted in the occurrence of the adverse event, and the costs of subsequent hospitalisations/stays, which were its consequences. The study was conducted in the period from October 2020 to November of 2021.
The statistical analysis of the examined cases enabled establishing that in 62% they concerned women. Only 38% were events which applied to men. The highest number of cases concerned events which occurred in the last years, that is 2018 (35%), 2019 (23%), and 2017 (17%). The most frequent events included those related to incorrect diagnosis (the lack of correct diagnosis), which resulted in appropriate activities not being undertaken and a lack of appropriate treatment, e.g., lack of diagnosis of cancer, myocardial infarction, appendicitis, or fracture (26%). The next one was incorrect surgical treatment (17%)-the consequence of which was most frequently a need for repeated surgery and an incorrect conservative treatment of injuries. The obtained results demonstrate that significantly higher funds are spent by medical entities for "restorative" actions (on average EUR 1433, which attempt to mitigate against the negative consequences of incorrect decisions or actions in the original treatment (average cost of EUR 814)).
The consequences of adverse events include not only health-related harm for the patient, but also long-term social, familial, or professional results. The authors of the article are of an opinion that all the conducted analyses and conclusions drawn from them should serve the improvement of patient safety. They also form an initial point for establishing recommendations and advice for the improvement of safety and quality of medical services and the reduction of healthcare-related costs. The authors propose covering the parties injured by an adverse event (subjected to "secondary harm") with a unique, innovative programme of post-accident health care, "Health Reconstruction".
由于需要治疗不良事件的后果以及患者（或其家属）提出的索赔数量和由此产生的赔偿，全球医疗保健支出不断增加，这意味着人们对不良事件成本管理这一主题的兴趣日益增加。近年来，波兰发生的医疗事故案件数量也有所增加。司法部的最新统计数据表明，法院的裁决金额越来越高。本文的目的是尝试根据我们自己的经验，估算不良事件对波兰医疗保健系统支出的影响，包括作者称之为“二次伤害”的此类事件后果的治疗成本。
基于对 100 例医疗事件赔偿案例的分析，对初始治疗（初始）费用进行初步估算，该费用导致不良事件的发生，以及随后的住院/住院费用，这是其后果。该研究在 2020 年 10 月至 2021 年 11 月期间进行。
对检查案例的统计分析使我们能够确定，其中 62%涉及女性。只有 38%是针对男性的事件。数量最多的案例涉及最近几年发生的事件，即 2018 年（35%）、2019 年（23%）和 2017 年（17%）。最常见的事件包括与不正确诊断相关的事件（缺乏正确诊断），这导致没有采取适当的活动和没有适当的治疗，例如缺乏癌症、心肌梗塞、阑尾炎或骨折的诊断（26%）。下一个是不正确的手术治疗（17%）-这是需要再次手术和不正确的创伤保守治疗的后果。结果表明，医疗实体在“恢复性”行动上花费了显著更高的资金（平均 1433 欧元，试图减轻原始治疗中错误决策或行动的负面影响（平均成本为 814 欧元））。
不良事件的后果不仅包括患者的健康相关伤害，还包括长期的社会、家庭或职业后果。本文作者认为，所有进行的分析和从中得出的结论都应有助于提高患者安全性。它们还构成了制定建议和改善医疗服务安全性和质量以及降低医疗保健相关成本的建议的初始点。作者建议为遭受不良事件（遭受“二次伤害”）的各方提供独特的创新的事后医疗保健计划，即“健康重建”。
