According to the 2015 Risk Panorama, healthcare establishments received 5,819 complaints following bodily injury. Surgery is the specialty most in question.
What are the risks associated with care in health facilities. This is the question answered on Tuesday by Sham, the leading medical liability insurer in France, in its Risk Overview 2015.
Based on data collected from 10,000 of its members, the insurer is able to announce that all types of claims are increasing: 12,546 in 2014, i.e. +5% compared to 2013.
Regarding the nature of these claims, most of the cost of establishments’ civil liability claims relates to bodily injury (98.1%). All for a total amount of compensation paid of 205.7 million euros (+ 4.5% compared to 2013).
The average cost per conviction thus stood at 272,845 euros in 2014 (+€16,000 compared to 2013). Finally, only 24 cases exceeded one million euros, a figure that is down from 27 in 2013.
In addition, acts of medical and paramedical care account for most of the claims. And it is this same care that is found in 1 complaint out of 2. The infection and the diagnosis come later.
On the professional side, with 3,260 complaints, surgery is the most questioned specialty (in number), led by surgeons working in orthopedics (1,206). Obstetrics remains the most expensive.
Source: Sham
More complaints
Still in this trend of increasing insurance risk, we note that the number of complaints related to a delay or an error in diagnosis increased by +8.5% in one year.
On the site CHU network, Dominique Godet, managing director of Sham, explains that this upsurge is the sign of a “greater requirement of patients towards health establishments”.
Thus, claims in anesthesia would be on the rise, even if in this specialty, “accidents are less serious thanks to the development of locoregional anesthesia “, he specifies.
On the good side, we find outpatient surgery with a stable number of complaints, which demonstrates “its more secure nature than traditional surgery”, according to Dominique Godet.
Also interesting is the drop in the number of complaints related to nosocomial infections (16.9% in 2014, compared to 18% in 2013). Most of them, as we know, occur during a short stay in hospital (source: BEH).
Finally, Sham reveals that the number of out-of-court settlements of these claims is progressing “including on files with high financial stakes”. These patients also see their complaint dealt with more quickly.
The only downside is that the median processing times for a claim vary from simple to more than threefold, depending on the procedures. The files treated amicably thus find a solution in 11 months. However, it will be necessary to wait 1 year and 7 months in the event of a referral to the Conciliation and Compensation Commission (CCI) and 3 years and 6 months for a dispute.
Source: Sham
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