title: [Inequity of compensation trajectories for victims of medical injuries. A survey in the French out-of-court settlement mechanism].
abstract: BACKGROUND
  In France little is known about either the characteristics of people who take legal action because they believe themselves to be victims of harm caused by medical activity, or about their complaint trajectory. The law of 4th March 2002 created an out-of-court settlement mechanism which aims to reduce inequitable access to compensation experienced by victims faced with legal procedures that are both lengthy and costly. This mechanism now occupies a central position among the avenues of recourse available to patients and their families.
  
  
  METHODS
  The study relates to the exhaustive database of 18,258 requests for compensation filed with the out-of-court settlement mechanism between 2003 and 2009. It takes 4 series of variables into account: (1) the characteristics of the people concerned by the request, (2) the recourse practices, (3) the result of the requests, (4) the characteristics of the commissions with whom they dealt. Univariate and multivariate analyses were performed, in particular to find factors relating to the different responses given to the requests.
  
  
  RESULTS
  Of the requests filed with the out-of-court settlement mechanism, 34.5% led to compensation being awarded, 30.7% were deemed inadmissible and 34.8% were rejected on the basis of expert opinions. The risk of inadmissibility was greater when the victim was a woman, undeceased, or a minor aged between 1 and 17; it bore no relation to standard of living. Recourse to a lawyer (24%) depended on various characteristics, in particular the age and vital status of the victim. It is associated to the decrease of the risk of inadmissibility and to the increase of the chances of receiving compensation. There were significant differences in the ways requests were processed (depending on where they were filed), in the time it took to examine the case, and in the tendency to reject requests before or after expert medical opinion.
  
  
  CONCLUSIONS
  This study offers the first ever description of the population of patients and families who accessed the out-of-court settlement mechanism for medical claims in France. It looks at how, within the mechanism, the diversity of practices impacts inequity and experiences during the compensation process.
authors.affiliation: CNRS, centre Maurice-Halbwachs (CMH), équipe de recherche sur les inégalités sociales (ERIS), 48, boulevard Jourdan, 75014 Paris, France. Electronic address: isabelle.parizot@ens.fr.
authors.forename: I
authors.initials: I
authors.lastname: Parizot
authors.affiliation: Inserm, centre de recherche, médecine, sciences, santé, santé mentale, société (Cermes3), 7, rue Guy-Môquet, 94801 Villejuif cedex, France.
authors.forename: I
authors.initials: I
authors.lastname: Cailbault
authors.affiliation: Inserm, centre de recherche, médecine, sciences, santé, santé mentale, société (Cermes3), 7, rue Guy-Môquet, 94801 Villejuif cedex, France.
authors.forename: M
authors.initials: M
authors.lastname: Winance
authors.affiliation: Inserm, institut Marcel-Mauss, centre d'étude des mouvements sociaux (IMM-CEMS), EHESS, 190, avenue de France, 75013 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Barbot
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D035881:Compensation and Redress / Q000331:legislation & jurisprudence; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007049:Iatrogenic Disease / Q000191:economics* / Q000453:epidemiology*; D007223:Infant; D007345:Insurance Claim Review; D033222:Judicial Role; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D008875:Middle Aged; D011640:Public Policy; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Accident médical; Compensation; Indemnisation; Medical injury; Patient complaint; Plainte des patients; Politique publique; Public policy