Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore
<h4>Introduction</h4> The resource burden of healthcare disputes and medico-legal claims has been rising. A dispute resolution system operating at the hospital level could ameliorate this disturbing trend. <h4>Methods</h4> This is a retrospective observational study on patien...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565668/?tool=EBI |
| _version_ | 1811182685801938944 |
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| author | Lee Theng Lim Wanlin Chen Thomas Wing Kit Lew Jackie Mui Siok Tan Seow Kiak Chang Daryl Zhang Wei Lee Thomas Swee Guan Chee |
| author_facet | Lee Theng Lim Wanlin Chen Thomas Wing Kit Lew Jackie Mui Siok Tan Seow Kiak Chang Daryl Zhang Wei Lee Thomas Swee Guan Chee |
| author_sort | Lee Theng Lim |
| collection | DOAJ |
| description | <h4>Introduction</h4> The resource burden of healthcare disputes and medico-legal claims has been rising. A dispute resolution system operating at the hospital level could ameliorate this disturbing trend. <h4>Methods</h4> This is a retrospective observational study on patient complaints and medico-legal cases received by the dispute resolution unit of an acute tertiary hospital from 2011 to 2015. We described the characteristics and analysed the resolution methodology and outcomes of all closed medico-legal cases. <h4>Results</h4> Patient complaints significantly increased at a compound annual growth rate (CAGR) of 4.2% (p<0.01), while medico-legal cases and ex-gratia payments for case settlements decreased at CAGRs of 4.8% (p<0.05) and 15.9% (p = 0.19), respectively. Out of 237 closed medico-legal cases, 88.6% were resolved without legal action, of which 78.1% were closed without any ex-gratia payments or waivers. Of the 11.4% of medico-legal cases that involved legal action, 66.7% were settled without ex-gratia payments or waivers. The primary resolution modes were the Patient Relations Service (PRS)’s engagement of the complainants and facilitation of written replies. No cases were brought to court. Cases were more likely resolved without legal action when there was engagement by the PRS (p = 0.009). These cases incurred a lower median settlement value than those with legal action. <h4>Conclusion</h4> Our hospital-based dispute resolution system which addressed patients’ core dissatisfactions and providers’ perspectives, through a process of early engagement, open disclosure, and fair negotiations, was able to promote claims resolution before legal action was taken. This early dispute resolution strategy contained costs and maintained provider-patient relationships and complements system-level mediation and arbitration to reduce medico-legal litigation. |
| first_indexed | 2024-04-11T09:36:00Z |
| format | Article |
| id | doaj.art-b21589b23aac4265b99fb4df2d0fb23c |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-11T09:36:00Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b21589b23aac4265b99fb4df2d0fb23c2022-12-22T04:31:43ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-011710Medico-legal dispute resolution: Experience of a tertiary-care hospital in SingaporeLee Theng LimWanlin ChenThomas Wing Kit LewJackie Mui Siok TanSeow Kiak ChangDaryl Zhang Wei LeeThomas Swee Guan Chee<h4>Introduction</h4> The resource burden of healthcare disputes and medico-legal claims has been rising. A dispute resolution system operating at the hospital level could ameliorate this disturbing trend. <h4>Methods</h4> This is a retrospective observational study on patient complaints and medico-legal cases received by the dispute resolution unit of an acute tertiary hospital from 2011 to 2015. We described the characteristics and analysed the resolution methodology and outcomes of all closed medico-legal cases. <h4>Results</h4> Patient complaints significantly increased at a compound annual growth rate (CAGR) of 4.2% (p<0.01), while medico-legal cases and ex-gratia payments for case settlements decreased at CAGRs of 4.8% (p<0.05) and 15.9% (p = 0.19), respectively. Out of 237 closed medico-legal cases, 88.6% were resolved without legal action, of which 78.1% were closed without any ex-gratia payments or waivers. Of the 11.4% of medico-legal cases that involved legal action, 66.7% were settled without ex-gratia payments or waivers. The primary resolution modes were the Patient Relations Service (PRS)’s engagement of the complainants and facilitation of written replies. No cases were brought to court. Cases were more likely resolved without legal action when there was engagement by the PRS (p = 0.009). These cases incurred a lower median settlement value than those with legal action. <h4>Conclusion</h4> Our hospital-based dispute resolution system which addressed patients’ core dissatisfactions and providers’ perspectives, through a process of early engagement, open disclosure, and fair negotiations, was able to promote claims resolution before legal action was taken. This early dispute resolution strategy contained costs and maintained provider-patient relationships and complements system-level mediation and arbitration to reduce medico-legal litigation.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565668/?tool=EBI |
| spellingShingle | Lee Theng Lim Wanlin Chen Thomas Wing Kit Lew Jackie Mui Siok Tan Seow Kiak Chang Daryl Zhang Wei Lee Thomas Swee Guan Chee Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore PLoS ONE |
| title | Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore |
| title_full | Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore |
| title_fullStr | Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore |
| title_full_unstemmed | Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore |
| title_short | Medico-legal dispute resolution: Experience of a tertiary-care hospital in Singapore |
| title_sort | medico legal dispute resolution experience of a tertiary care hospital in singapore |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9565668/?tool=EBI |
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