Correlation Between Malpractice Litigation and Legislation Reform in Taiwan Over a 30-Year Period

Hsieh, Ming-Ta; Lü, Lihui; Lin, Chi‐Wei; Chen, Yun-Wen

doi:10.2147/ijgm.s312640

Cited by 9 publications

(9 citation statements)

References 47 publications

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“…25 Meanwhile, a more powerful and effective medical liability system is needed to reduce MD. 1,[26][27][28][29] This study showed that males, longer working hours/ week, and lower job satisfaction were associated with MD, which was in line with other studies and empirical evidence. Female physicians usually have more patience and better communication skills than their male counterparts.…”

Section: Discussionsupporting

confidence: 91%

The Association Between Medical Liability Insurance Coverage and Medical Disturbances in Tertiary Psychiatric Hospitals in China: A National Survey

Luo¹,

Liu²,

Liu³

et al. 2021

RMHP

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Background Medical disturbances (MD), a severe type of medical disputes, are common in Chinese hospitals. Medical liability insurances were introduced to establish a new system of conflict resolution and risk management. However, data are scarce on the effects of medical liability insurance coverage and MD in psychiatric hospitals. This study was set to address it based on a nationwide survey. Methods A national cross-sectional survey was conducted in March 2019. Physicians in 41 tertiary psychiatric hospitals participated in a smartphone based anonymous questionnaire. Experience of MD, sociodemographic and occupational characteristics, and job satisfaction information were reported by physicians. The hospital medical liability insurance status was reported by participating hospitals. Multi-level logistic regression analysis was used to examine the association between medical liability insurance coverage and MD. Results In total, 4511 physicians completed the survey, 3760/4511 (83.35%) physicians in 32 hospitals had medical liability insurance coverage, and 1401/4511 (31.06%) physicians had encountered medical disturbances in the previous year. After adjusting for confounding factors, medical liability insurance coverage was not significantly associated with MD (OR=1.28, 95% CI: 0.93–1.76). Female gender, working in West China, and higher job satisfaction were protective factors for MD. Higher outpatient volume/week (>50 patients/week) and longer working hours/week were risk factors for MD. Conclusion Nearly one-third of physicians in Chinese top-tier psychiatric hospitals reported experience of MD. There was no significant association between medical liability insurance coverage and MD experienced among physicians in Chinese psychiatric hospitals. Policymakers and hospital administrators need to tailor the scope of medical liability insurance and to focus on other factors to reduce MD, including reducing workload and improving the doctor–patient relationship.

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Section: Discussionsupporting

confidence: 91%

The Association Between Medical Liability Insurance Coverage and Medical Disturbances in Tertiary Psychiatric Hospitals in China: A National Survey

Luo¹,

Liu²,

Liu³

et al. 2021

RMHP

View full text Add to dashboard Cite

show abstract

“…As a recent study revealed, the percentage of criminal cases was 4.7 times higher than that of civil cases in medical disputes litigation, however, the percentage of "no-fault" cases was 4.5 times higher than that of "negligence" and "possible negligence" cases. 25 To guide patients to use adequate channels for complaints and solve disputes, policymakers in Taiwan proposed the Medical Malpractice Resolution and Compensation Act as the alternative dispute resolution for medical malpractice litigations in 2012, and the annual medical litigation rate declined by 38% from 2012 to 2018. 25 However, when we conducted this study at the end of 2017, the fear of litigation and criminal procedures was still quite prevalent among our interviewees.…”

Section: Discussionmentioning

confidence: 99%

“…25 To guide patients to use adequate channels for complaints and solve disputes, policymakers in Taiwan proposed the Medical Malpractice Resolution and Compensation Act as the alternative dispute resolution for medical malpractice litigations in 2012, and the annual medical litigation rate declined by 38% from 2012 to 2018. 25 However, when we conducted this study at the end of 2017, the fear of litigation and criminal procedures was still quite prevalent among our interviewees. This is probably because frequent use of criminal law channels was considered as a hostile reaction of patients and intimidating to physicians.…”

Section: Discussionmentioning

confidence: 99%

Correspondence and address reprint request to: Yi-Lun Tsai

Tsai

2023

Preprint

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Background Medical malpractice and the problem associated with it remain an important issue in the medical community, yet relatively little is known regarding the nature of the fear of medical malpractice disputes of physicians. Aim This study aims to investigate the nature of hospital-employed physicians’ fear of medical malpractice disputes in Taiwan. Methods In-depth interviews were conducted to explore physicians’ personal experiences and observations of medical malpractice disputes. Thirty hospital-employed physicians varying in age, subspecialties, gender, institution, length of time in practice, and affiliation participated in this study. Results Physicians’ fear of medical malpractice disputes could be classified into two major categories, namely perceived negative consequences and perceived risk factors. Perceived negative consequences consist of (1) litigation (2) adversarial confrontation (3) reputation damage (4) psychological stress. Perceived risk factors consist of (1) medical uncertainty (2) work overload (3) influence of the National Health Insurance (4) weakened physician-patient relationship. Conclusion Physicians’ fear of medical malpractice disputes is not just about litigation but about other aspects. To reduce physicians’ fear, tort reforms are not sufficient, instead, other strategies such as adequate protection and psychological support of physicians are needed if a medical malpractice dispute has taken place. Physicians’ workloads and quality of medical care delivered should be ensured under the Budget Planning of National Health Insurance, as well as restoring a collaborative physician-patient relationship.

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“…However, research on medical dispute resolution methods has focused more on litigation [29][30][31][32][33][34][35]; some studies have emphasized the role of mediation, but research into the characteristics, e ciency, and in uencing factors of TPM in resolving medical disputes using a large number of detailed cases is lacking [19,27,29,36]. Therefore, we analyzed TPM practices using data from 5,948 cases in Chinese public hospitals from 2014 to 2019 in Gansu, a western province in China.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the characteristics, efficiency, and influencing factors of third-party mediation mechanisms for resolving medical disputes in public hospitals in China using 5,948 cases

Shen

Tang

et al. 2023

Preprint

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Background: Medical disputes, which are prevalent in China, are a growing global public health problem. The Chinese government has proposed third-party mediation (TPM) to resolve this issue. However, the characteristics, efficiency, and influencing factors of TPM in resolving medical disputes in public hospitals in China have yet to be determined. Methods: We conducted a systematic study using TPM records from medical disputes in Gansu Province in China from 2014 to 2019. A χ2 test was used to compare differences between groups, and binary logistic analysis was performed to determine the factors influencing the choice of TPM for resolving medical disputes. Results: We analyzed 5,948 TPM records of medical disputes in Gansu Province in China. The number of medical disputes and the amount of compensation awarded in public hospitals in the Gansu Province increased annually from 2014 to 2019, with most of the disputes occurring in secondary and tertiary hospitals. Approximately 89.01% of the medical disputes were handled by TPM; the average compensation amount with TPM was Chinese Yuan (CNY) 48,688.73, significantly less than that awarded via court judgment and judicial mediation. Moreover, compensation amounts, non-fatal outcomes, and no-fault liability determinations influence the choice of TPM for settling medical disputes. Conclusion: Our findings demonstrate that TPM mechanisms play a positive role in efficiently reducing compensation amounts and increasing medical dispute resolution rates.

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Correlation Between Malpractice Litigation and Legislation Reform in Taiwan Over a 30-Year Period

Cited by 9 publications

References 47 publications

The Association Between Medical Liability Insurance Coverage and Medical Disturbances in Tertiary Psychiatric Hospitals in China: A National Survey

The Association Between Medical Liability Insurance Coverage and Medical Disturbances in Tertiary Psychiatric Hospitals in China: A National Survey

Correspondence and address reprint request to: Yi-Lun Tsai

Analysis of the characteristics, efficiency, and influencing factors of third-party mediation mechanisms for resolving medical disputes in public hospitals in China using 5,948 cases

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