Patient and hospital characteristics associated with claims and compensations for patient injuries in coronary artery bypass grafting in Finland.
OBJECTIVE
To analyse the association between individual patients' risk factors and rates of claims and compensations for patient injuries in an insurance scheme in which proof of negligence is not required. And to explore whether either hospital productivity or volume of procedures is related to claims and compensation rates.


METHODS
A two-step sequential logistic regression was applied on data collected from administrative registers. It included 17,834 patients who had undergone coronary artery bypass grafting at public hospitals in Finland between 1998 and 2002. The main outcome measure was the odds of claiming and receiving compensation.


RESULTS
Men were less likely to claim compensation (odds ratio [OR] 0.66; 95% confidence interval 0.54-0.81), but among those having claimed were more likely to receive compensation (OR 2.08; 1.15-3.75) than women. Patients with a co-morbidity were more likely to claim (OR 1.29; 1.06-1.57), but among those having claimed were less likely to receive compensation (OR 0.52; 0.31-0.86) than those without a co-morbidity. Advanced age reduced the probability of claiming (OR 0.71; 0.52-0.96).


CONCLUSIONS
Although high-risk patients file a claim more frequently than low-risk patients, the latter have a higher probability of getting their claims accepted and receiving compensation. This risk pattern is probably a reflection of compensation practices related to patient injuries involving an infection.
Järvelin
Jutta
J
Centre for Health Economics - CHESS, National Institute for Health and Welfare, Helsinki, Findland. jutta.jarvelin@thc.fi
Rosenqvist
Gunnar
G
Häkkinen
Unto
U
Sintonen
Harri
H
D035881:Compensation and Redress; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000191:economics*; D005260:Female; D005387:Finland; D006761:Hospitals; D006801:Humans; D007345:Insurance Claim Review; D016015:Logistic Models; D008297:Male; D011183:Postoperative Complications / Q000191:economics; D012307:Risk Factors