RESUMO
This study reports on the analysis of medical complaints presented to the National Commission on Medical Arbitration (Comisión Nacional de Arbitraje Médico, CONAMED) between June 1996 and December 2007 to determine its magnitude and to identify the causes of safety problems in medical care. Out of 182,407 complaints presented to CONAMED, 87% were resolved by the Office of Orientation and Management. The remaining 18,443 complaints were presented to the Council Directorate. Of those cases, 48% were resolved by an agreement between the complainants and the physicians, 31% were not resolved by this method, and 3% were irresolute complaints. The highest frequency of complaints was registered in the Federal District (Distrito Federal) and the State of México (Estado de México), mainly corresponding to social security institutions and private hospitals. Among the nine most frequently involved specialties, six were surgical specialties. Malpractice was identified in 25% of all cases. The principal demands of those making complaints were the refunding of expenses in patient medical care (51%) and indemnification (40%) and, in those, the average amount of payments was 4.6 times greater. Due to the incidence of medical complaints, it was reasonable to investigate the causes and to take preventive and corrective actions required for its decrease. It was proposed to the Mexican Academy of Surgery that this organization should use their educational leadership and assume the vanguard in the dissemination and promotion of the WHO plan "Safe Surgery Saves Lives" and the implementation in Mexico of the "Surgical Safety Checklist."
Assuntos
Erros Médicos/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/normas , HumanosRESUMO
Se analizan los asuntos presentados ante la Comisión Nacional de Arbitraje Médico desde junio de 1996 hasta diciembre de 2007, para difundir su magnitud e identificar los problemas de seguridad en la atención médica. De 182 407 asuntos, 87 % lo resolvió el Área de Orientación y Gestión. Las restantes 18 443 quejas fueron derivadas a la Dirección de Conciliación; de ellas, en 48 % se logró la conciliación entre promoventes y médicos y en 31 % esto no fue factible; 3 % se trató de quejas irresolubles. La mayor frecuencia de quejas se registró en el Distrito Federal y Estado de México, principalmente correspondientes a instituciones de seguridad social y hospitales privados. Entre las nueve especialidades involucradas con mayor frecuencia, existieron seis quirúrgicas. Se identificó mala práctica en 25 % de los casos. Las principales pretensiones de los promoventes de las quejas fueron reintegro de los gastos erogados por atención médica en 51 % de los casos e indemnización en 40 %; en estos últimos el monto promedio de lo pagado por caso fue 4.6 veces mayor. El conocimiento de las quejas médicas permite investigar sus causas y generar acciones preventivas y correctivas, para su abatimiento. Se propone que la Academia Mexicana de Cirugía, por su liderazgo académico y docente, asuma la vanguardia en la difusión y promoción del plan Las prácticas quirúrgicas seguras salvan vidas, de la Organización Mundial de la Salud, y la implantación en nuestro país de la Lista de verificación de la seguridad quirúrgica.
This study reports on the analysis of medical complaints presented to the National Commission on Medical Arbitration (Comisión Nacional de Arbitraje Médico, CONAMED) between June 1996 and December 2007 to determine its magnitude and to identify the causes of safety problems in medical care. Out of 182,407 complaints presented to CONAMED, 87% were resolved by the Office of Orientation and Management. The remaining 18,443 complaints were presented to the Council Directorate. Of those cases, 48% were resolved by an agreement between the complainants and the physicians, 31% were not resolved by this method, and 3% were irresolute complaints. The highest frequency of complaints was registered in the Federal District (Distrito Federal) and the State of México (Estado de México), mainly corresponding to social security institutions and private hospitals. Among the nine most frequently involved specialties, six were surgical specialties. Malpractice was identified in 25% of all cases. The principal demands of those making complaints were the refunding of expenses in patient medical care (51%) and indemnification (40%) and, in those, the average amount of payments was 4.6 times greater. Due to the incidence of medical complaints, it was reasonable to investigate the causes and to take preventive and corrective actions required for its decrease. It was proposed to the Mexican Academy of Surgery that this organization should use their educational leadership and assume the vanguard in the dissemination and promotion of the WHO plan "Safe Surgery Saves Lives" and the implementation in Mexico of the "Surgical Safety Checklist."