title: Analysis of medical litigation among patients with medical disputes in cosmetic surgery in Taiwan.
abstract: BACKGROUND
  This study aimed to investigate the key factors in medical disputes (arguments) among female patients after cosmetic surgery in Taiwan and to explore the correlates of medical litigation.
  
  
  METHODS
  A total of 6,888 patients (3,210 patients from two hospitals and 3,678 patients from two clinics) received cosmetic surgery from January 2001 to December 2009. The inclusion criteria specified female patients with a medical dispute. Chi-square testing and multiple logistic regression analysis were used to analyze the data.
  
  
  RESULTS
  Of the 43 patients who had a medical dispute (hospitals, 0.53%; clinics, 0.73%), 9 plaintiffs eventually filed suit against their plastic surgeons. Such an outcome exhibited a decreasing annual trend. The hospitals and clinics did not differ significantly in terms of patient profiles. The Chi-square test showed that most patients with a medical dispute (p < 0.05) were older than 30 years, were divorced or married, had received operations under general anesthesia, had no economic stress, had a history of medical litigation, and eventually did not sue the surgeons. The test results also showed that the surgeon's seniority and experience significantly influenced the possibility of medical dispute and nonlitigation. Multiple logistical regression analysis further showed that the patients who did decide to enter into litigation had two main related factors: marital stress (odds ratio [OR], 10.67; 95% confidence interval [CI], 1.20-94.73) and an education level below junior college (OR, 9.33; 95% CI, 1.01-86.36).
  
  
  CONCLUSIONS
  The study findings suggest that the key characteristics of patients and surgeons should be taken into consideration not only in the search for ways to enhance pre- and postoperative communication but also as useful information for expert testimony in the inquisitorial law system.
authors.affiliation: School of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 11031, Taiwan. sylyu@tmu.edu.tw
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Lyu
authors.forename: Chuh-Kai
authors.initials: CK
authors.lastname: Liao
authors.forename: Kao-Ping
authors.initials: KP
authors.lastname: Chang
authors.forename: Shang-Ta
authors.initials: ST
authors.lastname: Tsai
authors.forename: Ming-Been
authors.initials: MB
authors.lastname: Lee
authors.forename: Feng-Chou
authors.initials: FC
authors.lastname: Tsai
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data; D015331:Cohort Studies; D003142:Communication; D016001:Confidence Intervals; D003906:Developing Countries; D034462:Dissent and Disputes / Q000331:legislation & jurisprudence; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007603:Jurisprudence; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008875:Middle Aged; D016017:Odds Ratio; D010817:Physician-Patient Relations; D011300:Preoperative Care; D012189:Retrospective Studies; D018570:Risk Assessment; D013518:Surgery, Plastic / Q000331:legislation & jurisprudence* / Q000379:methods; D013624:Taiwan; D055815:Young Adult