First report on public sector medical indemnity claims

Obstetrics, accident and emergency, and general surgery were the areas of clinical practice most frequently recorded in medical indemnity claims in the public sector between July 2003 and June 2004, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

Medical Indemnity National Data Collection: Public Sector 2003 to 2004 examined nearly 5,000 current and finalised claims in the public sector. It is the first national report on medical indemnity claims covering a full financial year. A report, combining public and private sector medical indemnity claims data, is planned for release in 2006.

The report shows that, in 2003-04 there were 825 public sector obstetrics claims current during the reported period, which accounted for 17% of all claims. Accident and emergency accounted for 710 claims (14%), general surgery 561 claims (11%), and gynaecology 414 claims (8%).

Of all of the claims examined, 5% fell into the reserve range of greater than $500,000. (A reserve range is the estimated size of the claim, recorded in broad dollar ranges). Paediatrics was the area which had the greatest proportion of current claims with a reserve range of greater than $500,000 (14%). Just over half, or 52%, of all current claims had a reserve range of less than $30,000.

AIHW spokesperson Ros Madden said that it was important to note that these were public sector results, and that 'at this stage we don't know whether the private sector will show a similar or very different pattern with respect to claims'.

'Secondly, we want to point out that the report represents a profile of medical indemnity claims data only-fault or negligence on the part of the health care provider is not necessarily established'.

The AIHW report was based on a new data collection developed in cooperation with all Australian Health Authorities. A working group was convened following recognition by Health Ministers in 2002 that a 'national database for medical negligence claims' should be established, to assist in determining future medical indemnity strategies.

Ms Madden said that the data collection arose in the broader context of national policy concern related to health care litigation, associated costs, and the financial viability of private sector medical indemnity insurers.

A benefit of the data collection is that it can inform clinical risk management reviews and ultimately improve quality outcomes in health care services to the community.

'To date, the absence of national data has made it difficult to analyse trends in the number, nature and cost of medical indemnity claims. But, thanks to the cooperation of all parties on this project, we are well on the way'.

Other findings of the report include:

  • Out of 860 finalised claims as at 30 June 2004, 340 (or 40%) were settled out of court. Only 48 finalised claims were settled by court decision.
  • Over half of all finalised claims had either no payment made or a payment of less than $10,000.
  • Women represented 58% of all claims involving adults, and were relatively more likely to be involved in procedural-related incidents (66% of the 1,192 claims in this category).


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