Dronkers Wouter J, Buis Dennis R, Amelink Quirine J M A, Bouma Gert-Joan, Peul Wilco C, Vandertop W Peter, Broekman Marike L D, Hendriks Aart C, Dirven Clemens M F, Spoor Jochem K H
Department of Neurosurgery, Erasmus University Medical Centre Rotterdam, Rotterdam , The Netherlands.
Department of Neurosurgery, Amsterdam University Medical Centre, University of Amsterdam, Amsterdam , The Netherlands.
Neurosurgery. 2025 Mar 1;96(3):673-680. doi: 10.1227/neu.0000000000003117. Epub 2024 Jul 26.
Studying malpractice claims is important to improve quality of health care and patient safety and to educate the individual healthcare providers. The objective of this study was to describe characteristics of neurosurgical claims in the Netherlands.
A nationwide retrospective observational study of neurosurgery-related claims closed by Centramed and MediRisk, 2 major insurance companies in the Netherlands, was performed. Relevant data, including type of neurosurgical pathology, theme and category of the claim, type and severity of injury, outcome, and financial burden, were extracted from anonymized claim files. The estimated annual risk was used to determine the risk for claims by adjusting for the number of annually practicing neurosurgeons in the Netherlands.
A total of 388 claims against neurosurgeons were closed between 2007 and 2021. Liability was denied in a slight majority of claims (n = 230; 59%). The total burden during this period was €6 165 000 (amount paid out to patients: €5 497 000). The estimated annual risk per Dutch neurosurgeon for a claim was 15.5%, meaning 1 claim per 6.5 years. The case-level analysis of 238 available anonymized claims revealed that most claims were related to spinal pathology (81.5%), followed by cranial pathology (10.9%) and peripheral nerve (7.6%). The motivations for filing claims were mostly related to alleged surgical (56.3%) or diagnostic errors (22.3%). Most of these claims were denied (151/238; 63.4%), and fewer were settled (42/238; 17.6%), sustained (31/238; 13.0%), or closed without final decision (14/238; 5.9%).
Neurosurgery-related malpractice claims primarily involved spinal pathology and were mostly related to alleged treatment errors. Most claims did not result in compensation because there seemed to be no liability or culpable injury. However, the annual risk for a claim for Dutch neurosurgeons is considerable.
研究医疗事故索赔对于提高医疗质量和患者安全以及教育个体医疗服务提供者具有重要意义。本研究的目的是描述荷兰神经外科索赔的特征。
对荷兰两家主要保险公司Centramed和MediRisk结案的与神经外科相关的索赔进行了一项全国性回顾性观察研究。从匿名索赔文件中提取相关数据，包括神经外科病理学类型、索赔主题和类别、损伤类型和严重程度、结果以及经济负担。通过调整荷兰每年执业的神经外科医生数量，使用估计的年度风险来确定索赔风险。
2007年至2021年期间，共结案388起针对神经外科医生的索赔。略多数的索赔（n = 230；59%）被否认有责任。在此期间的总负担为616.5万欧元（支付给患者的金额：549.7万欧元）。荷兰每位神经外科医生每年的索赔估计风险为15.5%，即每6.5年发生1起索赔。对238份可用的匿名索赔进行的病例层面分析显示，大多数索赔与脊柱病理学相关（81.5%），其次是颅脑病理学（10.9%）和周围神经（7.6%）。提出索赔的动机主要与所谓的手术（56.3%）或诊断错误（22.3%）有关。这些索赔中的大多数被否认（151/238；63.4%），较少的索赔得到解决（42/238；17.6%）、维持原判（31/238；13.0%）或在没有最终决定的情况下结案（14/238；5.9%）。
与神经外科相关的医疗事故索赔主要涉及脊柱病理学，且大多与所谓的治疗错误有关。大多数索赔未导致赔偿，因为似乎不存在责任或应受谴责的伤害。然而，荷兰神经外科医生每年的索赔风险相当大。
