Abstract:
CONTEXT:In Sweden, patient malpractice claims are handled administratively and compensated if an independent physician review confirms patient injury resulting from medical error. Full access to all malpractice claims and hospital discharge data for the country provided a unique opportunity to assess the validity of patient claims as indicators of medical error and patient injury. OBJECTIVE:To determine: (1) the percentage of patient malpractice claims validated by independent physician review, (2) actual malpractice claims rates (claims frequency / clinical volume) and (3) differences between Swedish and other national malpractice claims rates. DESIGN, SETTING AND MATERIAL: Swedish national malpractice claims and hospital discharge data were combined, and malpractice claims rates were determined by county, hospital, hospital department, surgical procedure, patient age and sex and compared with published studies on medical error and malpractice. RESULTS:From 1997 to 2004, there were 23 364 inpatient malpractice claims filed by Swedish patients treated at hospitals reporting 11 514 798 discharges. The overall claims rate, 0.20%, was stable over the period of study and was similar to that found in other tort and administrative compensation systems. Over this 8-year period, 49.5% (range 47.0-52.6%) of filed claims were judged valid and eligible for compensation. Claims rates varied significantly across hospitals; surgical specialties accounted for 46% of discharges, but 88% of claims. There were also large differences in claims rates for procedures. CONCLUSIONS:Patient-generated malpractice claims, as collected in the Swedish malpractice insurance system and adjusted for clinical volumes, have a high validity, as assessed by standardised physician review, and provide unique new information on malpractice risks, preventable medical errors and patient injuries. Systematic collection and analysis of patient-generated quality of care complaints should be encouraged, regardless of the malpractice compensation system in use.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Pukk-Härenstam K,Ask J,Brommels M,Thor J,Penaloza RV,Gaffney FAdoi
10.1136/qshc.2007.022897subject
Has Abstractpub_date
2009-02-01 00:00:00pages
69-73issue
1000eissn
0032-5473issn
1469-0756pii
85/1000/69journal_volume
85pub_type
杂志文章,多中心研究abstract:BACKGROUND:Despite the importance of timely management of patients with inflammatory arthritis (IA), delays exist in its diagnosis and treatment. OBJECTIVE:To perform a systematic literature review to identify strategies addressing these delays to inform an American College of Rheumatology (ACR)/European League Agains...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2011-201063rep
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:Current treatment for osteoarthritis (OA) is limited. Many patients with OA of the hand have areas of tender subcutaneous thickening in the forearm and upper scapular region. A pilot study showed an improvement in pain from OA at the first carpometacarpal joint after injection of such areas with 0.5% sodium ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/pgmj.2009.087643
更新日期:2010-06-01 00:00:00
abstract::Repeated pneumonia and hypogammaglobulinaemia was associated with long term low dose steroid therapy. Clinical improvement with restoration of antibody levels followed substitution of aerosol for oral therapy. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.61.716.523
更新日期:1985-06-01 00:00:00
abstract::Leuco-erythroblastosis has many known associations (Burkett, Cox and Fields, 1965; Weick, Hagedorn and Linman, 1974; Retief, 1964), but the only ones related to drug therapy are the well established response to haematinics (Burkett et al., 1965) and one possible case following anti-epileptic therapy (Retief, 1964). Th...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.621.391
更新日期:1977-07-01 00:00:00
abstract::Candida albicans peritonitis developed in a 48-year-old man with a perforated gastric ulcer who subsequently was treated with intravenous amphotericin B. The drug penetrated well into the inflamed peritoneal cavity and eradicated the organism from the peritoneal fluid. Nevertheless, at post-mortem, Candida organisms w...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.631.340
更新日期:1978-05-01 00:00:00
abstract::The healthcare industry has seen an increase in the adoption of team training, such as crew resource management (CRM), to improve teamwork and coordination within acute care medical teams. A meta-analysis was carried out in order to quantify the effects of CRM training on reactions, learning, behaviour and clinical ca...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析
doi:10.1136/postgradmedj-2014-132800
更新日期:2014-12-01 00:00:00
abstract::Greater trochanteric pain syndrome (GTPS) is a commonly diagnosed regional pain syndrome with a wide spectrum of aetiologies, reflecting the anatomy of the structures outside the hip joint capsule. There are five muscle tendons that insert on to the greater trochanter and three bursae in the region of the greater troc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2013-131828
更新日期:2014-10-01 00:00:00
abstract::A patient is described in whom the presenting feature of hypopituitarism was the development of palmar xanthomata associated with type III hyperlipoproteinaemia. Treatment of her secondary hypothyroidism with thyroxine caused resolution of the xanthomata and hyperlipidaemia, but the underlying compositional abnormalit...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.746.1099
更新日期:1987-12-01 00:00:00
abstract::Ultrasound guidance has been reported to facilitate the performance of lumbar punctures (LPs). However, the use of ultrasound guidance has not yet received consistent conclusions. We performed a systematic review and meta-analysis to determine the efficacy of ultrasound-guided LPs. PubMed, Embase and the Cochrane Libr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2020-138238
更新日期:2021-01-01 00:00:00
abstract::Video evaluation of resuscitation is becoming increasingly integrated into practice in a number of clinical settings. The purpose of this review article is to examine how video may enhance clinical care during resuscitation. As healthcare and available therapeutic interventions evolve, re-evaluation of accepted paradi...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2016-134357
更新日期:2017-08-01 00:00:00
abstract:INTRODUCTION:Characteristics and outcomes of patients undergoing inferior vena cava (IVC) filter insertion are not well reported. Particularly, the role of long term anticoagulation in these patients is unclear. AIMS:(1) To describe in a cohort of patients undergoing IVC filter insertion, underlying diseases, indicati...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,多中心研究
doi:10.1136/pgmj.2005.037911
更新日期:2006-02-01 00:00:00
abstract::Heatstroke following vigorous exercise is reported in a young male. Severe hepatic and renal failure resulted but the patient completely recovered following treatment by active measures to reduce his core temperature. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.748.157
更新日期:1988-02-01 00:00:00
abstract::Methicillin-resistant Staphylococcus aureus (MRSA) has emerged worldwide as a significant and difficult-to-treat source of nosocomial infection, emphasizing the ever-present need for reliable and effective antisepsis. Betadine Solution (10% povidone-iodine; PVP-I) and Betadine Cream (5% povidone-iodine) are broad-spec...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::Aspirin was first synthesised 100 years ago and its preparation and marketing is generally reckoned to have been the foundation of the pharmaceutical industry. For most of the time since then it has been used for the relief of pain and fever. The modern phase of aspirin use commenced with the reporting in 1974 of a ra...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.74.876.587
更新日期:1998-10-01 00:00:00
abstract::Acute bacterial meningitis is a common neurological emergency and a leading cause of death and neurological disability worldwide. Diagnosis is based on clinical and microbiological findings with neuroimaging in the form of CT reserved for those with specific adverse clinical features or when an underlying cause such a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2010.097022
更新日期:2010-08-01 00:00:00
abstract::In 17 patients with essential hypertension administration of labetalol alone resulted in a significant reduction in supine systolic and diastolic blood pressure of 14% and 17%, respectively. Seven patients attained a diastolic pressure less than equal to 95 mmHg. A significant postural fall in systolic blood pressure ...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract:OBJECTIVE:Since many years, teaching and training in communication skills are cornerstones in the medical education curriculum. Although video recording in a real-time consultation is expected to positively contribute to the learning process, research on this topic is scarce. This study will focus on the feasibility an...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133633
更新日期:2016-08-01 00:00:00
abstract::A case of myxoedema coma is reported where the administration of chlorpromazine resulted in a prolonged dystonic reaction. A similar challenge with a butyrophenone when the patient was on thyroxine caused a similar but much abbreviated response. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.653.192
更新日期:1980-03-01 00:00:00
abstract::This report describes the case history of a middle-aged lady who presented with symptoms and signs over one year leading to a diagnosis of multiple sclerosis. During one of her relapses, she developed trismus--an association that has not been described before in multiple sclerosis. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.780.853
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVE:Lactate dehydrogenase (LDH) anomaly is one of the macroenzymes. Macroenzymes are enzymes in serum that have formed high molecular mass complexes, either by self polymerisation or by association with other serum components. The aim of this study was to identify the properties of LDH anomaly and observe the cha...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2003.015420
更新日期:2004-08-01 00:00:00
abstract:PURPOSE OF THE STUDY:Genome-wide association studies have revealed an association of ADAMTS7 polymorphisms with the risk of cardiovascular diseases. Nonetheless, the role of ADAMTS7 polymorphisms on myocardial infarction (MI) risk remains poorly understood. Here, we aim to evaluate the effect of ADAMTS7 tag single nucl...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2019-136459
更新日期:2019-09-01 00:00:00
abstract::By 30 June 1984, only 99 confirmed and probable cases of toxic shock syndrome (TSS) had been reported in the British Isles. Sixty-three were related to menstruation in women aged 14 to 54 years who used tampons of various brands and absorbencies; 33 (52%) of these cases were in girls under 20. Five women died (8%) and...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1985-01-01 00:00:00
abstract::The acute haemodynamic effects of endralazine, a new hydralazine-like vasodilating agent, were studied in 6 patients with stable angina pectoris and proven coronary artery disease. Twenty minutes after intravenous administration of 5 mg endralazine heart rate and cardiac index increase, while mean arterial blood press...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1983-01-01 00:00:00
abstract::Salivary gland lymphoma is associated with Sjögren's syndrome. A case of bilateral submandibular gland and sublingual gland lymphoma, arising in Sjögren's syndrome, is presented. A lymphoma involving more than one salivary gland may occur in Sjögren's syndrome, and there is an increased risk of developing an extrasali...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.736.135
更新日期:1987-02-01 00:00:00
abstract::A 21 year old woman presenting with galactorrhoea, hyperprolactinaemia, and a pituitary mass on magnetic resonance imaging (MRI) is described who was referred to us before planned pituitary surgery. Although a thorough history did not suggest hypothyroidism, laboratory studies revealed profound primary hypothyroidism....
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.76.894.232
更新日期:2000-04-01 00:00:00
abstract::Prolonged coma resulting from hypoxic brain injury is usually associated with a dismal chance of return to independent existence. In this report a case is described of a 60 year old man who recovered and returned to work as a university professor after being in a vegetative state at least 8 weeks after a prolonged cer...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.66.775.384
更新日期:1990-05-01 00:00:00
abstract:BACKGROUND:Benefits of exposure to global health training during medical education are well documented and residents' demand for this training is increasing. Despite this, it is offered by few US obstetrics and gynaecology (OBGYN) residency training programmes. OBJECTIVES:To evaluate interest, perceived importance, pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-133144
更新日期:2015-12-01 00:00:00
abstract::The case is reported of a patient presenting with recurrent acute myocardial infarction due to stent thrombosis resulting from possible clopidogrel resistance caused by interaction between clopidogrel and anti-tuberculosis drugs. A brief overview of drug interaction as a risk factor for clopidogrel resistance is given...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.2007.065193
更新日期:2008-04-01 00:00:00
abstract::A patient presented with retroperitoneal fibrosis but without any ureteric obstruction. The diagnosis was made by an abdominal CT scan and also at laparotomy. Post-operatively, she developed hypertensive encephalopathy. An isotope renogram with captopril was abnormal but not diagnostic of renal artery stenosis. The pa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.75.890.730
更新日期:1999-12-01 00:00:00
abstract::A case of hyperemesis gravidarum at 9 weeks' gestation is described for which no cause could initially be found. Intravenous feeding was needed as a life preserving measure and following improvement on this regime the patient went into a thyrotoxic crisis which was successfully diagnosed and treated. The continuing pr...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.56.660.746
更新日期:1980-10-01 00:00:00