COMPARATIVE ASSESSMENT OF THE FREQUENCY OF DEFECTS OF MEDICAL CARE TAKING INTO ACCOUNT THE LIKELIHOOD OF THE DEVELOPMENT OF THE SYNDROME OF EMOTIONAL BURNOUT AT DOCTORS

Abstract

The problem of proper / inadequate medical care (MC) in the forensic aspect is relevant for domestic healthcare. The reasons leading to the occurrence of defects in the MC vary from accidents and medical malpractice to careless actions and deliberate crimes of medical workers. However, during comprehensive forensic medical expertise (CFME), an important aspect of the problem remains out of sight of the researchers, particularly: the development of an emotional burnout syndrome (EBS) at doctor who has provided MC.
 The subject of the study are 208 conclusions of CFME, according to the archival material of the National Bureau of Expertise of the National Academy of Sciences of the Republic of Armenia for the period from 2006 to 2012, as well as 141 questionnaires of the EBS, filled by doctors in the framework expertise of “medical cases”. Defects in MC were classified as follows: diagnostics defects; treatment defects; defects in the organization of medical care; defects in keeping medical records.
 Research Purpose Assessment of the frequency of defects in the provision of medical care, taking into account the likelihood of the development of emotional burnout syndrome at doctors based on materials from comprehensive forensic medical expertise.
 According to the findings of CFME 408 MP defects were recorded. Defects of diagnostics are the most common (30.1%), the least common defects are the medical documentation defects (17.6%). Defects of MC were detected at doctors of 23 specialties. The first 3 “leading” places are occupied by surgeons, obstetricians-gynecologists and resuscitators (14.5%, 14.0% and 12.4%, respectively). The presence (58; 41, 1%) or the formation EBS (59; 41, 8%) was detected by the moment of providing CFME at the overwhelming number of doctors, which made MC defects. The absence of EBS was detected only at 24 respondents (17, 0%). EBS was present mostly at respondents, anesthesiologists, obstetricians-gynecologists, surgeons and pediatrician. An analysis of the relationship between the likelihood of EBS development and the frequency of allowed defects in providing MC has shown that as the EBS forms, the number of diagnostic defects, treatment defects and defects in keeping medical records increases.
 Thus, there are several specialties for which the development of the EBS is a very likely event: resuscitation, anesthesiology, gynecology and surgery, with the most severe degree of the EBS being developed by resuscitation and anesthesiologists. Formation of the EBS at doctors of various specialties is accompanied by an increase in the probability of occurrence of defects in MC. In this case, the most likely is the occurrence of defects in the treatment and documentation of anesthetists, gynecologists, resuscitators and surgeons. Here we should highlight the specialty "resuscitator" with the highest risk of treatment defects and defects in keeping medical records.