Evidence map›Paper›PMID 36240207›Full record

Observational studyPloS one2022

Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore.

Lee Theng Lim, Wanlin Chen, Thomas Wing Kit Lew, Jackie Mui Siok Tan, Seow Kiak Chang, Daryl Zhang Wei Lee, Thomas Swee Guan Chee

Abstract readObservational Study
In one paragraph

Observational study in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. The Impacts of Applications of Criminal Law on Medical Practice.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2022
    Review
  4. Indian Dental Malpractice Claims and Lawsuits: A Medico-Legal Analysis.Journal of International Society of Preventive & Community Dentistry
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Lee Theng LimOffice of Clinical Governance, Tan Tock Seng Hospital, Singapore, Singapore.ORCID 0000-0003-4745-1717
Wanlin ChenOffice of Clinical Governance, Tan Tock Seng Hospital, Singapore, Singapore.ORCID 0000-0002-4368-3409
Thomas Wing Kit LewNational Healthcare Group, Singapore, Singapore.
Jackie Mui Siok TanOffice of Clinical Governance, Tan Tock Seng Hospital, Singapore, Singapore.
Seow Kiak ChangOffice of Clinical Governance, Tan Tock Seng Hospital, Singapore, Singapore.
Daryl Zhang Wei LeeOffice of Clinical Governance, Tan Tock Seng Hospital, Singapore, Singapore.
Thomas Swee Guan CheeOffice of Clinical Governance, Tan Tock Seng Hospital, Singapore, Singapore.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe resource burden of healthcare disputes and medico-legal claims has been rising. A dispute resolution system operating at the hospital level could ameliorate this disturbing trend.

methodsThis is a retrospective observational study on patient complaints and medico-legal cases received by the dispute resolution unit of an acute tertiary hospital from 2011 to 2015. We described the characteristics and analysed the resolution methodology and outcomes of all closed medico-legal cases.

resultsPatient complaints significantly increased at a compound annual growth rate (CAGR) of 4.2% (p<0.01), while medico-legal cases and ex-gratia payments for case settlements decreased at CAGRs of 4.8% (p<0.05) and 15.9% (p = 0.19), respectively. Out of 237 closed medico-legal cases, 88.6% were resolved without legal action, of which 78.1% were closed without any ex-gratia payments or waivers. Of the 11.4% of medico-legal cases that involved legal action, 66.7% were settled without ex-gratia payments or waivers. The primary resolution modes were the Patient Relations Service (PRS)'s engagement of the complainants and facilitation of written replies. No cases were brought to court. Cases were more likely resolved without legal action when there was engagement by the PRS (p = 0.009). These cases incurred a lower median settlement value than those with legal action.

conclusionOur hospital-based dispute resolution system which addressed patients' core dissatisfactions and providers' perspectives, through a process of early engagement, open disclosure, and fair negotiations, was able to promote claims resolution before legal action was taken. This early dispute resolution strategy contained costs and maintained provider-patient relationships and complements system-level mediation and arbitration to reduce medico-legal litigation.

Indexed as

MalpracticeDissent and DisputesHumansNegotiatingSingaporeTertiary Care Centers

Identifiers

PMID36240207
PMCPMC9565668

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.