Medical Malpractice — The Canadian Experience

Coyte, Peter C.; Dewees, Donald N.; Trebilcock, Michael J.

doi:10.1056/nejm199101103240204

Cited by 38 publications

(14 citation statements)

References 6 publications

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“…This percentage is close to the corresponding values previously reported in China (67%), Japan (60%) and the USA (56%) but substantially higher than the value reported for Canada (33%) 5 , 6 , 32 , 38 . The between-country differences in this proportion probably reflect between-country differences in legal and medical systems and socioeconomic backgrounds.…”

Section: Discussionsupporting

confidence: 82%

Records of medical malpractice litigation: a potential indicator of health-care quality in China

Wang

Jiang

et al. 2017

Bull. World Health Organ.

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ObjectiveTo assess the characteristics and incidence of medical litigation in China and the potential usefulness of the records of such litigation as an indicator of health-care quality.MethodsWe investigated 13 620 cases of medical malpractice litigation that ended between 2010 and 2015 and were reported to China’s Supreme Court. We categorized each case according to location of the court, the year the litigation ended, the medical specialization involved, the severity of the reported injury, the type of allegation raised by the plaintiff – including any alleged shortcomings in the health care received – and the outcome of the litigation.FindingsThe annual incidence of medical malpractice litigation increased from 75 in 2010 to 6947 in 2014. Most cases related to general surgery (1350 litigations), internal medicine (3500 litigations), obstetrics and gynaecology (1251 litigations) and orthopaedics (1283 litigations). Most of the reported injuries were either minor (1358 injuries) or fatal (4111 deaths). The most frequent allegation was of lack of consent or notification (1356 litigations), followed by misdiagnosis (1172 litigations), delay in treatment (1145 litigations) and alteration or forgery of medical records (975 litigations). Of the 11 014 plaintiffs with known litigation outcomes, 7482 (67.9%) received monetary compensation.ConclusionOver our study period, the incidence of litigation over potential medical malpractice increased in China. As many of the cases related to alleged inadequacies in the quality of health care, records of medical malpractice litigation in China may be worth exploring as an indicator of health-care quality.

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Section: Discussionsupporting

confidence: 82%

Records of medical malpractice litigation: a potential indicator of health-care quality in China

Wang

Jiang

et al. 2017

Bull. World Health Organ.

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“…The USA spends nearly twice as much per capita on healthcare as Canada and has multiple funding models, while Canada has a universal, publicly funded healthcare system . In addition, AM physicians face more than eight times the number of lawsuits CDN physicians face . These differences may translate into differences in breast cancer surgery care and outcomes.…”

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confidence: 99%

Survey of American and Canadian General Surgeons' Perceptions of Margin Status and Practice Patterns for Breast Conserving Surgery

et al. 2014

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Although breast conservation surgery (BCS) is commonly performed, several aspects of the procedure remain controversial. We undertook a cross-sectional survey to compare Canadian (CDN) and American (AM) general surgeons' reported BCS practice patterns to better understand the cross-border differences in early-stage breast cancer surgery care. A modified Dillman Method survey was mailed to 1,447 AM and 1,443 CDN surgeons. Factors evaluated included preoperative assessment, margin definition, surgical techniques, and re-excision practices. The response rate was 26% and 51% for AM and CDN surgeons, respectively. There was variation in use of preoperative core biopsies. American surgeons required wider margins for invasive cancer and ductal carcinoma in situ, and more often recommend re-excision for invasive cancer with 1 and 2 mm margins (p < 0.05). There was also variability in surgical techniques used for intraoperative margin assessment. Wide variation in BCS practice was observed, with some of this variability related to surgeon country.

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“…While Canada shares the US fault-based malpractice model, tort reforms and other systemic legal differ-ences (such as rare use of contingency fees or punitive damages) result in Canadian physicians being sued approximately one quarter as frequently as their US counterparts and paying much lower premiums. [21][22][23] Comparing physicians' opinions about error disclosure and patient safety across countries could clarify whether these attitudes stem from country-specific issues, such as the malpractice environment. Furthermore, the malpractice environment differs depending on physicians' specialties.…”

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confidence: 99%

US and Canadian Physicians' Attitudes and Experiences Regarding Disclosing Errors to Patients

Gallagher¹,

Waterman²,

Garbutt³

et al. 2006

Arch Intern Med

201

161

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Medical Malpractice — The Canadian Experience

Cited by 38 publications

References 6 publications

Records of medical malpractice litigation: a potential indicator of health-care quality in China

Records of medical malpractice litigation: a potential indicator of health-care quality in China

Survey of American and Canadian General Surgeons' Perceptions of Margin Status and Practice Patterns for Breast Conserving Surgery

US and Canadian Physicians' Attitudes and Experiences Regarding Disclosing Errors to Patients

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