Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki-shi, Nagasaki, Japan.
Graduate School of Health Management, Faculty of Nursing and Medical Care, Keio University, Fujisawa-shi, Kanagawa, Japan.
PLoS One. 2023 May 19;18(5):e0283332. doi: 10.1371/journal.pone.0283332. eCollection 2023.
Globally, residents of long-term care facilities (LTCFs) often experience adverse events (AEs) and corresponding lawsuits that result in suffering among the residents, their families, and the facilities. Hence, we conducted a study to clarify the factors related to the facilities' liabilities for damages for the AEs that occur at LTCFs in Japan. We analyzed 1,495 AE reports from LTCFs in one Japanese city. A binomial logistic regression analysis was conducted to identify factors associated with liability for damages. The independent variables were classified as: residents, organizations, and social factors. In total, 14% of AEs resulted in the facility being liable for damages. The predictors of liability for damages were as follows: for the resident factors, the increased need for care had an adjusted odds ratio (AOR) of 2.00 and care levels of 2-3; and AOR of 2.48 and care levels of 4-5. The types of injuries, such as bruises, wounds, and fractures, had AORs of 3.16, 2.62, and 2.50, respectively. Regarding the organization factors, the AE time, such as noon or evening, had an AOR of 1.85. If the AE occurred indoors, the AOR was 2.78, and if it occurred during staff care, the AOR was 2.11. For any follow-ups requiring consultation with a doctor, the AOR was 4.70, and for hospitalization, the AOR was 1.76. Regarding the type of LTCF providing medical care in addition to residential care, the AOR was 4.39. Regarding the social factors, the reports filed before 2017 had an AOR of 0.58. The results of the organization factors suggest that liability tends to arise in situations where the residents and their family expect high quality care. Therefore, it is imperative to strengthen organizational factors in such situations to avoid AEs and the resulting liability for damages.
在全球范围内，长期护理机构（LTCF）的居民经常经历不良事件（AEs）和相应的诉讼，导致居民、他们的家人和机构遭受痛苦。因此，我们进行了一项研究，以澄清与日本 LTCF 发生的 AEs 相关的设施损害赔偿责任的因素。我们分析了一个日本城市的 1495 份 LTCF 的 AE 报告。采用二项逻辑回归分析确定与损害赔偿责任相关的因素。自变量分为：居民、组织和社会因素。总的来说，14%的 AE 导致设施承担损害赔偿责任。损害赔偿责任的预测因子如下：对于居民因素，增加的护理需求调整后的优势比（AOR）为 2.00，护理水平为 2-3；AOR 为 2.48，护理水平为 4-5。伤害类型，如瘀伤、伤口和骨折，分别有 AOR 为 3.16、2.62 和 2.50。关于组织因素，AE 时间，如中午或晚上，有一个 AOR 为 1.85。如果 AE 发生在室内，AOR 为 2.78，如果发生在员工护理期间，AOR 为 2.11。任何需要咨询医生的后续行动，AOR 为 4.70，住院治疗，AOR 为 1.76。关于除住宅护理外还提供医疗护理的 LTCF 类型，AOR 为 4.39。关于社会因素，2017 年之前提交的报告 AOR 为 0.58。组织因素的结果表明，在居民及其家属期望高质量护理的情况下，责任往往会产生。因此，在这种情况下，必须加强组织因素，以避免 AE 和由此产生的损害赔偿责任。
