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当前爱尔兰的医学法律环境:不可持续的发展轨迹。

Current Irish medicolegal landscape: an unsustainable trajectory.

机构信息

Academic Track Intern Programme, Intern Network Executive, School of Medicine, University College Cork, Cork, Ireland

Pregnancy Loss Research Group, University College Cork, Cork, Ireland.

出版信息

BMJ Open Qual. 2023 Aug;12(3). doi: 10.1136/bmjoq-2023-002433. Epub 2023 Aug 22.

Abstract

A number of outstanding clinical claims that are yet to be resolved as well as their associated estimated costs are at a record high in Ireland. By the end of 2022, the Irish government face 3875 active clinical claims which are expected to cost €3.85 billion in total. This does not account for future claims yet to be brought. The financial burden will be borne by the Irish healthcare system which is already facing unprecedented pressures on its services and staff. If current trends continue, the opportunity costs of the current medicolegal landscape will impact the future provision of healthcare. Aside from the financial consequences, clinical claims have numerous negative impacts on all parties involved. Gaining an understanding as to why claims and costs continue to increase relies on access to, and analysis of high-quality patient safety data, including learning from previous litigation. Addressing the causal and perpetuating factors requires efficient implementation of evidence-based recommendations through engagement with stakeholders, including the public. It is necessary to continuously assess the implementation of recommendations as well as measure their impact. This is to ensure that novel efforts from this point onwards do not suffer the same fate as many previous recommendations that, because of a lack of follow-on research, appear to go no further than the page of the report they are written. Action is required now to change the course of the currently unsustainable trajectory of the Irish medicolegal landscape.

摘要

爱尔兰有许多悬而未决的杰出临床索赔,以及与之相关的估计成本,达到了历史最高水平。截至 2022 年底,爱尔兰政府面临 3875 项活跃的临床索赔,预计总费用为 38.5 亿欧元。这还不包括未来尚未提出的索赔。财政负担将由爱尔兰医疗保健系统承担,该系统的服务和员工已经面临前所未有的压力。如果当前的趋势持续下去,当前医疗法律环境的机会成本将影响未来的医疗保健提供。除了财务后果外,临床索赔对所有相关方都有许多负面影响。要了解为什么索赔和成本持续增加,需要获得高质量的患者安全数据,并对其进行分析,包括从以往的诉讼中吸取教训。解决因果和持续因素需要通过与利益相关者(包括公众)进行接触,有效地实施基于证据的建议。有必要不断评估建议的实施情况,并衡量其影响。这是为了确保从现在开始的新努力不会重蹈许多先前建议的覆辙,因为缺乏后续研究,这些建议似乎除了报告本身之外,没有进一步的发展。现在需要采取行动改变爱尔兰医疗法律环境目前不可持续的轨迹。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5611/10445350/794988dcd686/bmjoq-2023-002433f01.jpg

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