Obstetric claims in Finland 2012-2022-A nationwide patient insurance registry study.
compensation
injury claim
obstetrics
operative delivery
patient safety
register‐based study
substandard care
Journal
Acta obstetricia et gynecologica Scandinavica
ISSN: 1600-0412
Titre abrégé: Acta Obstet Gynecol Scand
Pays: United States
ID NLM: 0370343
Informations de publication
Date de publication:
06 May 2024
06 May 2024
Historique:
revised:
16
04
2024
received:
30
01
2024
accepted:
18
04
2024
medline:
7
5
2024
pubmed:
7
5
2024
entrez:
7
5
2024
Statut:
aheadofprint
Résumé
Maternal and infant mortality rates in Finland are among the lowest in the world, yet preventable obstetric injuries occur every year. The aim of this study was to describe obstetric claims, their compensation rates, and temporal trends of claims reported to the Patient Insurance Centre. A nationwide, register-based study was conducted. Data consisted of obstetric claims reported to the Patient Insurance Centre between 2012 and 2022. Data analyzed included the year of injury, compensation criteria, maternal age, birth hospital, delivery method, reported causes of injury, and maternal or neonatal injury. The data were analyzed with descriptive statistics and logistic regression models. A total of n = 849 obstetric claims were filed during the study period, of which n = 224 (26.4%) received compensation. The rate of claims was 0.15%, and the rate of compensation was 0.04% in relation to the total volume of births during the period. Substandard care was the most common (97.3%) criterion for compensation. There was a curvilinear increase in the claims rate and a linear increase in compensation rates from 2013 to 2019. More claims were filed and compensated for cesarean and vacuum-assisted deliveries than for unassisted vaginal deliveries. Delayed delivery (18.7%) and surgical technique failure (10.9%) were the most reported causes of injuries. Retained surgical bodies were the induced cause of injury with the highest rate of compensated claims (86.7%). The most common maternal injury was infection (17.9%) and pain (11.7%). Among neonatal injuries, severe (19.2%) and mild asphyxia (16.6%) were the most frequent. Burn injuries (93.3%) and fetal or neonatal death (60.5%) had the highest rate of compensated claims. The study provided new information on substandard care and injuries in obstetric care in Finland. An increasing trend in claims and compensation rates was found. Identifying contributors to substandard care that lead to fetal asphyxia is important for improving obstetric safety. Further analysis of the association of claims and compensation rates with operative deliveries is needed to determine their causality. Frequent review of obstetric claims would be useful in providing more recent data on substandard care and preventable injuries.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).
Références
Hüner B, Derksen C, Schmiedhofer M, Lippke S, Janni W, Scholz C. Preventable adverse events in obstetrics—systemic assessment of their incidence and linked risk factors. Healthcare. 2022;10:97.
Kekki M, Salonen A, Tihtonen K, Mattila VM, Gissler M, Huttunen TT. The incidence of birth injuries decreased in Finland between 1997 and 2017: a nationwide register study. Acta Paediatr. 2020;109:2562‐2569.
Eppes CS, Han SB, Haddock AJ, Buckler AG, Davidson CM, Hollier LM. Enhancing obstetric safety through best practices. J Womens Health (Larchmt). 2021;30:265‐269.
McCormick M, Pollock W, Kapp S, Gerdtz M. Organizational strategies to optimize women's safety during labor and birth: a scoping review. Birth. 2021;48:285‐300.
Arshia A. Role of nurses and midwives in improving patient safety during childbirth: evidence from obstetric trauma in OECD countries. Appl Nurs Res. 2020;56:151343.
Skoogh A, Bååth C, Sandin Bojö AK, Hall‐Lord ML. Healthcare professionals' perceptions of patient safety for the woman in childbirth in Sweden—an interview study. Nurs Open. 2019;7:642‐649.
Johansen LT, Braut GS, Acharya G, Andresen JF, Øian P. Adverse events reporting by obstetric units in Norway as part of their quality assurance and patient safety work: an analysis of practice. BMC Health Serv Res. 2021;21:931.
Pyykönen A. Quality and Patient Safety in Obstetric Care: Benchmarks for Improvement. University of Helsinki, Academic dissertation; 2017. Accessed October 4, 2023. https://helda.helsinki.fi/server/api/core/bitstreams/74fadad4‐4573‐4392‐91de‐cbd895c6cab6/content
Andreasen S, Backe B, Jørstad RG, Oian P. A nationwide descriptive study of obstetric claims for compensation in Norway. Acta Obstet Gynecol Scand. 2012;91:1191‐1195.
Berglund S, Grunewald C, Pettersson H, Cnattingius S. Severe asphyxia due to delivery‐related malpractice in Sweden 1990‐2005. BJOG. 2008;115:316‐323.
Milland M, Mikkelsen KL, Christoffersen JK, Hedegaard M. Severe and fatal obstetric injury claims in relation to labor unit volume. Acta Obstet Gynecol Scand. 2015;94:534‐541.
Kurki T. Analysis of obstetric complications reported to the National Patient Insurance Association in Finland from 1987 to 1995. Acta Obstet Gynecol Scand. 1997;76:839‐842.
Official Statistics of Finland 2022. Perinatal Statistics – Parturients, Deliveries and Newborns 2022. Statistics of Finland; 2023. Accessed December 10, 2023. https://www.julkari.fi/bitstream/handle/10024/147689/Perinataalitilasto%20%e2%80%93%20synnytt%c3%a4j%c3%a4t%2c%20synnytykset%20ja%20vastasyntyneet%202022.pdf?sequence=8&isAllowed=y
Nordic Statistics Database. CHIL02: Fertility rates by age, time and reporting country. 2023 Accessed December 10, 2023. https://www.nordicstatistics.org/news/all‐time‐low‐nordic‐fertility‐rates/
Vilkko R, Räisänen S, Gissler M, Stefanovic V, Kalliala I, Heinonen S. Busy day effect on adverse obstetric outcomes using a nationwide ecosystem approach: cross‐sectional register study of 601 247 hospital deliveries. BJOG. 2023;130:1328‐1336.
Welling M, Takala A. Patterns of malpractice claims and compensation after surgical procedures: a retrospective analysis of 8901 claims from the Finnish patient insurance registry. Patient Saf Surg. 2023;17:3.
Lamminpää R, Vehviläinen‐Julkunen K, Gissler M, Selander T, Heinonen S. Pregnancy outcomes of overweight and obese women aged 35 years or older—a registry‐based study in Finland. Obes Res Clin Pract. 2016;10:133‐142.
Pratt A, Howat P, Hui L. Maternal and perinatal outcomes for women with body mass index ≥50 kg/m2 in a non‐tertiary hospital setting. Aust N Z J Obstet Gynaecol. 2020;60:361‐368.
Langley‐Evans SC, Pearce J, Ellis S. Overweight, obesity and excessive weight gain in pregnancy as risk factors for adverse pregnancy outcomes: a narrative review. J Hum Nutr Diet. 2022;35:250‐264.
Johansen LT, Braut GS, Acharya G, Andresen JF, Øian P. How common is substandard obstetric care in adverse events of birth asphyxia, shoulder dystocia and postpartum hemorrhage? Findings from an external inspection of Norwegian maternity units. Acta Obstet Gynecol Scand. 2021;100:139‐146.
Wen Q, Muraca GM, Ting J, Coad S, Lim KI, Lisonkova S. Temporal trends in severe maternal and neonatal trauma during childbirth: a population‐based observational study. BMJ Open. 2018;8:e020578.
Muraca G, Lisonkova S, Skoll A, et al. Ecological association between operative vaginal delivery and obstetric and birth trauma. CMAJ. 2018;190(24):E734‐E741.
Chawanpaiboon S, Titapant V, Pooliam J. Maternal complications and risk factors associated with assisted vaginal delivery. BMC Pregnancy Childbirth. 2023;23:756.
Humphreys ABC, Linsell L, Knight M. Factors associated with infection after operative vaginal birth‐a secondary analysis of a randomized controlled trial of prophylactic antibiotics for the prevention of infection following operative vaginal birth. Am J Obstet Gynecol. 2023;228:328.e1‐328.e11.
Blomquist JL, Muñoz A, Carroll M, Handa VL. Association of delivery mode with pelvic floor disorders after childbirth. JAMA. 2018;320:2438‐2447.
Cass GKS, Goyder K, Strachan B, Bahl R. Can we improve women's experience of operative vaginal birth? Eur J Obstet Gynecol Reprod Biol. 2020;252:424‐430.
Falk M, Nelson M, Blomberg M. The impact of obstetric interventions and complications on women's satisfaction with childbirth a population based cohort study including 16 000 women. BMC Pregnancy Childbirth. 2019;19:494.
Bossano CM, Townsend KM, Walton AC, Blomquist JL, Handa VL. The maternal childbirth experience more than a decade after delivery. Am J Obstet Gynecol. 2017;217:342.e1‐342.e8.
Walløe S, Bogh SB, Birkeland SF, et al. Using complaints from obstetric care for improving women's birth experiences—a cross sectional study. BMC Pregnancy Childbirth. 2023;23(1):705.
Floris L, Irion O, Courvoisier D. Influence of obstetrical events on satisfaction and anxiety during childbirth: a prospective longitudinal study. Psychol Health Med. 2017;22:969‐977.
Kempe P, Vikström‐Bolin M. Women's satisfaction with the birthing experience in relation to duration of labour, obstetric interventions and mode of birth. Eur J Obstet Gynecol Reprod Biol. 2020;246:156‐159.
NHS. Never events policy and framework. 2018. Accessed December 5, 2023. https://www.england.nhs.uk/wp‐content/uploads/2020/11/Revised‐Never‐Events‐policy‐and‐framework‐FINAL.pdf
Smith CA, Levett KM, Collins CT, Dahlen HG, Ee CC, Suganuma M. Massage, reflexology and other manual methods for pain management in labour. Cochrane Database Syst Rev. 2018;3:CD009290.
Bromiley M, Mitchell L. Would you speak up if the consultant got it wrong? …and would you listen if someone said you'd got it wrong? J Perioper Pract. 2009;19:326‐329.
Pettker CM, Grobman WA. Obstetric safety and quality. Obstet Gynecol. 2015;126:196‐206.
Järvelin J, Häkkinen U. Can patient injury claims be utilised as a quality indicator? Health Policy. 2012;104:155‐162.