title: Investigations of complaints and quality of health care.
abstract: Malpractice law is frequently justified by the claim that it improves health care services but this belief remains untested. Using a multiple case study in 16 remote rural areas in New Zealand, this study examined the effects of formal quasi-judicial investigations on the quality of health care services. The study found that the fragile local health systems were damaged by the quasi-judicial investigations of the medical disciplinary body and became less efficient and less user-friendly. A few doctors left rural practice and were difficult to replace. The remaining health workers responded to the investigations in a negative manner, losing confidence, enthusiasm and motivation for work; they performed in a less efficient manner, working more slowly, setting up barriers to access, ordering more tests and referring more to secondary care. Complainants also appeared to have been disadvantaged as a consequence of having complained.
authors.affiliation: University of Auckland, New Zealand.
authors.forename: R F
authors.initials: RF
authors.lastname: Henderson
authors.forename: N
authors.initials: N
authors.lastname: North
authors.forename: G
authors.initials: G
authors.lastname: Patterson
mesh_terms: D003258:Consumer Behavior; D006801:Humans; D008318:Malpractice / Q000331:legislation & jurisprudence*; D009520:New Zealand; D011787:Quality of Health Care; D019035:Rural Health Services