Abstract
BackgroundLegislative measures have been identified as one effective way of changing attitude or behaviour towards health care. The aim of this study was to describe trends in patients' complaints for medical issues; to evaluate the contribution of a law regarding patients' rights, and to identify factors associated to patients' perception of a medical error.MethodsPatients with a complaint letter for medical issues in a French university hospital were included. Trends in complaint rates were analysed. Comparisons were made between a first (1998–2000) and a second (2001–2004) time period, before and after the diffusion of the law, and according to the perception of a medical error.ResultsComplaints for medical issues increased from 1998 to 2004. Of 164 complaints analysed, 66% were motivated by the perception of a medical error (47% during the first time period vs. 73% during the second time period; p = 0.001). Error or delay in diagnosis/treatment and surgical/medical complication were the main reasons for complaints. Surgical departments had the higher number of complaints. Second time period, substandard care, disability, and adverse effect of a health product were independently associated with the perception of a medical error, positively for the formers, and negatively for the latter.ConclusionThis study revealed an increase with time in the number of complaints for medical issues in a university hospital, as well as an increase in the perception of a medical error after the passing of a law regarding patients' rights in France.
Highlights
Legislative measures have been identified as one effective way of changing attitude or behaviour towards health care
Characteristics of study population and complaints Women accounted for 63% of complaint letters for medical issues
The complaint was written by a lawyer in 42% of cases, whereas the affected patient was the author in 41% of cases
Summary
Legislative measures have been identified as one effective way of changing attitude or behaviour towards health care. The United States, for example, since November 1997 have included an aspirational statement in the Consumer Bill of Rights regarding this issue [9] In this country, where iatrogenesis is the third leading cause of death [10], increasing patients' participation in their care, reducing health care errors, and ensuring the appropriate use of health care services are among the national aims for improving the quality of health care [11,12]. In France, considerable efforts have been made in the past 20 years to improve in-hospital safety management through laws and regulations [15,16,17] Patients found their rights supported by a law [17] developed in 2001 by the health authorities and voted in by Parliament on 4 March 2002. All these measures may have contributed to an increased expectation of patients towards the health system and may have facilitated the act of officially addressing a complaint
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