Kurki T
Department of Obstetrics and Gynecology, University Central Hospital of Helsinki, Finland.
Acta Obstet Gynecol Scand. 1997 Oct;76(9):839-42. doi: 10.3109/00016349709024362.
The launch of the National Patient Insurance Association in 1987 offered a good starting point to evaluate obstetric claims in Finland. In order to obtain full compensation after patient injury, proof of malpractice is no longer required. Thus, the register of the Association offers a solid data base to analyze these injuries.
A nationwide descriptive study of obstetric claims reported to the National Patient Insurance Association from 1.5.1987 to 31.12.1995. The recorded statistical datafiles of the Association were used in the analysis.
A total of 801 obstetric claims were analyzed. This comprised 2% of all (n = 39189) claims during the same time period. Nearly all injuries leading to claims (683/801, 85%) occurred during delivery. In all, 156 (19.5%) claims resulted in compensation. The total sum of compensation paid was $ 1.3 million. Most often (30/80 37.5%) and highest compensation ($ 0.8 million) was paid due to delay in the diagnosis of fetal asphyxia. In all, 118 (0.3%) malpractice trials in court have arisen from all claims to the Association during the study period; only two (1.7%) resulted from obstetric causes.
The data indicate that most common and serious obstetric complications are associated with delay in the diagnosis of fetal asphyxia. Thus, from both the legal and the medical points of view, pertinent fetal monitoring during delivery and umbilical artery blood gas analysis after delivery in all risk deliveries should be obligatory in all delivery units. Finally, and perhaps most importantly, the patient insurance has effectively prevented obstetric malpractice trials in court.
1987年国家患者保险协会的成立为评估芬兰的产科索赔提供了一个良好的起点。为了在患者受伤后获得全额赔偿，不再需要医疗事故证明。因此，该协会的登记册为分析这些伤害提供了坚实的数据库。
对1987年5月1日至1995年12月31日向国家患者保险协会报告的产科索赔进行全国性描述性研究。分析使用了该协会记录的统计数据文件。
共分析了801例产科索赔。这占同一时期所有（n = 39189）索赔的2%。几乎所有导致索赔的伤害（683/801，85%）都发生在分娩期间。总共有156例（19.5%）索赔获得了赔偿。支付的赔偿总额为130万美元。最常见（30/80，37.5%）且赔偿金额最高（80万美元）的是由于胎儿窒息诊断延迟。在研究期间，该协会收到的所有索赔引发了118例（0.3%）法庭医疗事故审判；只有两例（1.7%）是由产科原因导致的。
数据表明，最常见和严重的产科并发症与胎儿窒息诊断延迟有关。因此，从法律和医学角度来看，所有分娩单位在所有有风险的分娩中，分娩期间进行相关的胎儿监测以及分娩后进行脐动脉血气分析都应是强制性的。最后，也许最重要的是，患者保险有效地防止了法庭上的产科医疗事故审判。
