UOS Risk Management Fondazione Policlinico A. Gemelli IRCCS, Department of Health Surveillance and Bioethics, Section of Legal Medicine, School of Medicine, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy.
Fondazione Policlinico A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy.
Int J Environ Res Public Health. 2022 Dec 5;19(23):16253. doi: 10.3390/ijerph192316253.
Incident reporting is an important method to identify risks because learning from the reports is crucial in developing and implementing effective improvements. A medical malpractice claims analysis is an important tool in any case. Both incident reports and claims show cases of damage caused to patients, despite incident reporting comprising near misses, cases where no event occurred and no-harm events. We therefore compare the two worlds to assess whether they are similar or definitively different. From 1 January 2014 to 31 December 2021, the claims database of Policlinico Universitario A. Gemelli IRCCS collected 843 claims. From 1 January 2020 to 31 December 2021, the incident-reporting database collected 1919 events. In order to compare the two, we used IBNR calculation, usually adopted by the insurance industry to determine loss to a company and to evaluate the real number of adverse events that occurred. Indeed, the number of reported adverse events almost overlapped with the total number of events, which is indicative that incurred-but-not-reported events are practically irrelevant. The distribution of damage events reported as claims in the period from 1 January 2020 to 31 December 2021 and related to incidents that occurred in the months of the same period, grouped by quarter, was then compared with the distribution of damage events reported as adverse events and sentinel events in the same period, grouped by quarter. The analysis of the claims database showed that the claims trend is slightly decreasing. However, the analysis of the reports database showed that, in the period 2020-2021, the reports trend was increasing. In our study, the comparison of the two, malpractice claims and incident reporting, documented many differences and weak areas of overlap. Nevertheless, this contribution represents the first attempt to compare the two and new studies focusing on single types of adverse events are, therefore, desirable.
事件报告是识别风险的重要方法，因为从报告中学习对于制定和实施有效的改进措施至关重要。医疗事故索赔分析是任何情况下的重要工具。事件报告和索赔都显示了对患者造成损害的案例，尽管事件报告包括未遂事件、未发生事件和无伤害事件。因此，我们将这两个世界进行比较，以评估它们是否相似或完全不同。从 2014 年 1 月 1 日至 2021 年 12 月 31 日， Policlinico Universitario A. Gemelli IRCCS 的索赔数据库共收集了 843 份索赔。从 2020 年 1 月 1 日至 2021 年 12 月 31 日，事件报告数据库共收集了 1919 起事件。为了进行比较，我们使用了 IBNR 计算，这是保险公司通常用来确定公司损失和评估实际发生的不良事件数量的方法。事实上，报告的不良事件数量几乎与总事件数量重叠，这表明已发生但未报告的事件实际上并不重要。然后，将 2020 年 1 月至 2021 年 12 月期间报告的索赔中按季度分组的损害事件的分布情况与同期报告的不良事件和哨点事件的分布情况进行比较。索赔数据库的分析显示，索赔趋势略有下降。然而，报告数据库的分析显示，在 2020-2021 年期间，报告的趋势在增加。在我们的研究中，对这两者的比较表明，医疗事故索赔和事件报告存在许多差异和重叠不足的地方。尽管如此，这一贡献代表了首次尝试对两者进行比较，因此需要进行新的研究，重点关注单一类型的不良事件。
