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Analysis of the causes of surgery-related medical disputes in Taiwan: Need for acute care surgeons to improve quality of care
- Source :
- Journal of the Chinese Medical Association, Vol 79, Iss 11, Pp 609-613 (2016)
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Background This study investigated surgery-related medical disputes and analyzed disease etiologies and the main causes of disputes in order to identify key points for the purpose of improving the quality of surgical patient care in Taiwan. Methods Reports on all surgery-related cases appraised by the Taiwan Witness Examiner Committee of the Department of Health between 2004 and 2008 were reviewed retrospectively by three senior physicians from the emergency department who specialize in both trauma and emergency general surgery. The causes of the various medical disputes were categorized under the following descriptions: operation- or procedure-related complication, anesthesia complication, inappropriate management or decision, delayed diagnosis or misdiagnosis, and unsatisfactory result. Results A total of 154 cases were reviewed, of which 39 were trauma-related and 115 were disease-related. The two leading causes of disputes in this review were found to be operation- or procedure-related complications (35.7%) and unsatisfactory results (31.8%), followed by delayed diagnoses or misdiagnoses, inappropriate management, and anesthesia complications. Among these, 74 cases (48.1%) required the care of an acute care surgeon and 40 cases (26.0%) required emergency general surgery intervention. Conclusion Surgery- or procedure-related complications and unsatisfactory treatment results constituted the major causes of medical disputes in Taiwan. The majority of these cases involved acute care surgery; thus, the establishment of an acute care surgery system should be considered to improve patient care. The management of hemorrhagic shock and incarcerated hernia should be reinforced in future medical training.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Disease
emergency general surgery
Young Adult
03 medical and health sciences
0302 clinical medicine
Intervention (counseling)
Acute care
Humans
Medicine
030212 general & internal medicine
medical dispute
Medical diagnosis
Child
Aged
Retrospective Studies
Aged, 80 and over
Surgeons
Medicine(all)
lcsh:R5-920
acute care surgery
incarcerated hernia
business.industry
Anesthesia complication
Infant, Newborn
Infant
Retrospective cohort study
General Medicine
Emergency department
Middle Aged
medicine.disease
Dissent and Disputes
Quality Improvement
Surgery
trauma
Child, Preschool
Surgical Procedures, Operative
030220 oncology & carcinogenesis
Etiology
Female
Medical emergency
lcsh:Medicine (General)
business
Subjects
Details
- ISSN :
- 17264901
- Volume :
- 79
- Issue :
- 11
- Database :
- OpenAIRE
- Journal :
- Journal of the Chinese Medical Association
- Accession number :
- edsair.doi.dedup.....4285917ea41b5178bc045c7e4b57ce2a
- Full Text :
- https://doi.org/10.1016/j.jcma.2016.04.008