Patient Reported Injuries After Ventral Hernia Repair.
Female
Hernia, Ventral
/ epidemiology
Herniorrhaphy
/ adverse effects
Humans
Iatrogenic Disease
/ epidemiology
Insurance Claim Review
Insurance, Liability
/ statistics & numerical data
Laparoscopy
/ adverse effects
Male
Malpractice
/ legislation & jurisprudence
Patient Reported Outcome Measures
Postoperative Complications
/ epidemiology
Registries
Retrospective Studies
Self Report
Sweden
/ epidemiology
Ventral hernia
enterotomy
hernia repair
iatrogenic patient injury
insurance
laparoscopic repair
local anesthesia
Journal
Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society
ISSN: 1799-7267
Titre abrégé: Scand J Surg
Pays: England
ID NLM: 101144297
Informations de publication
Date de publication:
Mar 2019
Mar 2019
Historique:
pubmed:
4
7
2018
medline:
14
6
2019
entrez:
4
7
2018
Statut:
ppublish
Résumé
The Swedish National Patient Insurance Company (LÖF) can compensate patients who believe they have been exposed to an avoidable injury or malpractice in healthcare. Its register covers 95% of Swedish healthcare providers. Data on patients operated for primary or incisional ventral hernia in Sweden between 2010 and 2015 and who had filed a claim, were retrieved from LÖF. A total of 290 cases were identified and included. Files include a copy of records, relevant imaging, and an expert advisor's opinion. Inadvertent enterotomy occurred during 25 repairs and in these cases, laparoscopic repair was clearly overrepresented ( p < 0.001). Complications related to the surgical site (infection and ugly scar) were predominantly related to open repairs ( p < 0.001). Twenty percentage (57/290) of the claims were directly related to an anesthetic mishap. Univariate ordinal regression showed that the odds of receiving a high reimbursement was significantly increased if laparoscopic repair was performed p < 0.001 (odds ratio: 0.37; 95% confidence interval: 0.21-0.65). Sixty-three percentage of claims were filed by women. Inadvertent enterotomy is overrepresented, and the probability that a claim filed for an avoidable injury leads to high reimbursement is greater if laparoscopic repair is performed rather than open ventral hernia repair. The high amount of injuries related to general anesthesia during umbilical hernia repair may be reduced with an increased proportion executed in local anesthesia.
Sections du résumé
BACKGROUND AND AIMS:
UNASSIGNED
The Swedish National Patient Insurance Company (LÖF) can compensate patients who believe they have been exposed to an avoidable injury or malpractice in healthcare. Its register covers 95% of Swedish healthcare providers.
MATERIAL AND METHODS:
UNASSIGNED
Data on patients operated for primary or incisional ventral hernia in Sweden between 2010 and 2015 and who had filed a claim, were retrieved from LÖF. A total of 290 cases were identified and included. Files include a copy of records, relevant imaging, and an expert advisor's opinion.
RESULTS:
UNASSIGNED
Inadvertent enterotomy occurred during 25 repairs and in these cases, laparoscopic repair was clearly overrepresented ( p < 0.001). Complications related to the surgical site (infection and ugly scar) were predominantly related to open repairs ( p < 0.001). Twenty percentage (57/290) of the claims were directly related to an anesthetic mishap. Univariate ordinal regression showed that the odds of receiving a high reimbursement was significantly increased if laparoscopic repair was performed p < 0.001 (odds ratio: 0.37; 95% confidence interval: 0.21-0.65). Sixty-three percentage of claims were filed by women.
CONCLUSION:
UNASSIGNED
Inadvertent enterotomy is overrepresented, and the probability that a claim filed for an avoidable injury leads to high reimbursement is greater if laparoscopic repair is performed rather than open ventral hernia repair. The high amount of injuries related to general anesthesia during umbilical hernia repair may be reduced with an increased proportion executed in local anesthesia.
Identifiants
pubmed: 29966500
doi: 10.1177/1457496918783727
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM