The comparative study of the Mongolian Health professional’s liability insurance system with some foreign countries / Шинэ санаа Шинэ нээлт

ABSTRACT

Risk management practice and decision making are paramount for doctors to improving patient outcomes and managing the total cost of risk in our evolving healthcare landscape. In Mongolia there are no legal regulations about health professional’s liability insurance. The aim of the study is to provide relative information about the legal environment, systems and financing of liability insurancefor health professionals in selected foreign countries and Mongolia and to look at what policies and regulations could be applied to Mongolia.We carried out a policy study focused on health professionals’ liability insurance in four selectedcountries. We investigated health professionals’ liability insurance situation in Mongolia in the year of 2012-2014 byReviewing and analyzing the data related to health professionals liability insurance voluntary from the top six insurance companies’ by size and interviewing managerial level staff at these companies Studying court decisions related to health professionals’ errors to see how many health professionals could be prevented from court hearing Studying patients’ complaints against health professionals as filed with the Ministry of Health andSports to see how much risks are facing by health professionals.There are two main legal systems we discovered regarding resolution of health professionals’accountability for patient complaints Court sentencing. Examples include Mongolia and the United States. Reimbursing the loss. Examples include Switzerland, Finland, New Zealand, Canada, Australia, England, and the Russian Federation. There are two insurance types for health professional’s liability А. Compulsory B. Voluntary1 In USA, Canada and England, the liability insurance system for health care providers developed late in 19th and earlier in 20th century. Today, both private and nonprofit insurance entities in these countries insure health professionals and members of the health professionals’ association. England has rich experience of health professional’s liability insurance and the system is too large. Data fromthe England legal system shows that one case may take up to 4 years to receive a final decision. In order to determine health professionals’ fault with regard to claims, a health professionals’ liability damage assessor is needed who is well experienced and trained in healthcare law. Mostly not more than 30 percent of the claims are reimbursed. In Canada, statistical trends show claims against health professionals continue to increase. As a result, doctors prescribe additional laboratory tests and other additional investigations which increase health sector costs. In Russia in 2010 the health professional’s liability insurance law is approved and the implementationwill start January 2017. In Mongolia in 2012-2014, there were registered 373 complaints and errors against health professionals and 162 clients applied court complaints. During this period, 27 health professionals received court sentences. Health professionals liability insurance premium is calculated 0.8-3.5 percent of the insurance valuation. In 2012-2014 total 4377 health professionals insured voluntarily against professional liability.In most developed countries health professionals are protected from sentence to court. Averagecomplaints against health professionals have continued to increase steadily similarly in other countries.Therefore health professional’s professional risk is increasing. It shows that it is very important to improve the legal environment of the liability insurance system for Mongolian health professionals. of coronary atherosclerosis.