A new report by the Australian Institute of Health and Welfare (AIHW) shows that just over 30% of public and private sector medical indemnity claims made in 2004-05 were for harm or loss that allegedly resulted from an error or negligence in a medical or surgical procedure.
Ms Jenny Hargreaves, Head of the Institute’s Economics and Health Services Group said claims were most often made for 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.
‘Less commonly, claims related to diagnosis issues (23.6%), for example, failure to correctly diagnose a problem or a misdiagnosis.
‘Treatment issues were the reason behind 13.2% of claims and included delayed treatment, failure to provide treatment, and complications arising from treatment,’ she said.
The report, A national picture of medical indemnity claims in Australia 2004-05, is the first to contain information about medical indemnity claims filed in both the public and private health care sectors.
It covers incidents that gave rise to medical indemnity claims, the medical specialties involved in those claims, the people affected, the nature of injury, and the size of the claims, the claim outcomes and the length of time claims have been open.
‘It is important to note however, 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,’ Ms Hargreaves said.
Of all the claims filed from 1 July 2004 to 30 June 2005, 62.0% involved adults, 4.7% related to children, and babies were the subject of 3.6% of the claims. In 29.7% of claims there was no information on age.
Over three quarters (77.1%) of claims finalised in the 2004-05 financial year had a total claim size of less than $100,000. Claims with sizes in excess of $500,000 constituted 1.7% of all finalised claims.
‘Although information for private hospitals is not available, previous medical indemnity reports have only presented public sector claims data so this report constitutes a significant step towards making comprehensive medical indemnity information available,’ Ms Hargreaves said.