Medical and surgical procedure claims most common

A new report by the Australian Institute of Health and Welfare (AIHW) shows that claims for harm or loss alleged to have resulted from an error or negligence in a medical or surgical procedure made up over 34% (2,361 claims) of all medical indemnity claims in the public sector in 2005-06.

The report, Medical indemnity national data collection public sector 2005-06, examined the 6,922 claims that were active during the year, and found that 19.8% (1,372 claims) related to diagnosis issues, such as a failure to correctly diagnose a problem or a misdiagnosis.

Treatment issues, such as delayed treatment, failure to provide treatment, and complications arising from treatment were the reasons for 13.7% (946 claims) of medical indemnity claims.

'Examples include failure to perform a procedure, having the wrong procedure performed, having a procedure performed on the wrong part of the body, post-operative complications and failure of procedure,' said Ms Jenny Hargreaves, Senior Executive of the AIHW's Economics and Health Services Group.

Settlement through court decisions represented 4% of finalised claims, with most claims being settled through dispute resolution or other processes.

The majority (83.3%) of claims closed in the 2005-06 financial year had a total claim size of less than $100,000 including 458 claims where no payment was made. Just under 4% of claims were settled for payments in excess of $500,000.

During this period 4,802 claims involved adults, 687 related to babies, and children were the subject of 520 medical indemnity claims.

'It is important to note that the report represents a profile of national public sector medical indemnity claims data only - fault or negligence on the part of the health care provider is not necessarily established,' Ms Hargreaves said.

The report includes 89% of all claims made in the public sector, which is an increase of 4% in completeness from the previous report, and is the first in this series to include information about three consecutive financial years of claims data.

It covers incidents that gave rise to medical indemnity claims, the medical specialties involved in those claims, the nature of injury, and the size of the claims and other aspects of medical indemnity claims in the public sector.


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