Legal aspects of assessing the quality of medical care

Abstract

Introduction. The analysis of adverse outcomes of medical care allows to identify the causes and eliminate the possibility of their further recurrence, and contributes to the accumulation of practical experience. Objectives. To determine the degree of correlation of examinations of the quality of medical care conducted by medical organizations, insurance companies and investigating authorities, and to assess the validity of using the expression “defect in the provision of medical care”. Materials and methods. The main research method was the analysis of the conclusions of the Commission for the Study of Lethal Outcomes (CSLO), acts of inspections of the quality examination conducted by insurance companies and the conclusions of forensic medical examinations for the frequency of use of the expression “defect in the provision of medical care”, “medical error”, “shortcomings in the provision of medical help”. The data was obtained from the results of a study of 24 CSLO protocols, 15 acts of quality examination inspections conducted by insurance companies and 12 forensic medical examination reports. In all cases, the studied documents were associated with adverse outcomes of medical care, with the participation of anesthesiologists-resuscitators. Results. When analyzing these documents, it was found that the expression “defect in the provision of medical care” is more often found in the conclusions of forensic medical examinations — 91.7 %. When examining the quality of medical care, this term is found in only 13.3 % and in the protocols of CSLO in 54.2 %, and “deficiencies in the provision of medical care” — in 41.6 %. Conclusions. The analysis revealed that in the documents reflecting the quality of care, there is a terminology that is different in meaning and content, which does not allow to objectively reflect the degree of the admitted deficiency and its impact on the outcome of the disease.