In the Journals

Medical error disclosure policy helped cut claims, costs

Instituting a medical error disclosure program at one institution decreased gastroenterology-related claims, saved money in settlement dollars, claims-related costs and total liability, and shortened the period of time to resolving those claims, according to a recent study.

The study examined 66 claims — 38 before implementing a disclosure, apology and offer policy related to errors, and 28 after implementation — in 2001 at the University of Michigan Health System. Among claims, 15.2 % alleged delay in diagnosis or misdiagnosis, 42.4% were related to a procedure, and 42.4 % involved alleged improper management, treatment, or monitoring.

The pre-implementation claims came among 238,911 gastrointestinal (GI) encounters, while the remaining claims involved 411,944 GI cases — a reduction (P=.001) in the proportion of encounters resulting in a claim, with claim rates per 1,000 encounters dropping from 0.16% pre-implementation to 0.068% post-implementation.

The time to resolve claims was cut in half, from 1,000 days for pre-implementation claims to 460 days post-implementation (P<.0001).

Mean total liability fell by 52%, from $167,309 before implementation of the new program to $81,107 (95% CI, 33,682.5–300,936.2 for pre-implementation vs. 1,687.8–160,526.7 post-implementation). The difference was not considered significant because of sample size.

While the researchers noted their data were institution-specific and did not prove causality, they concluded that results confirmed disclosure, apology and offer programs can result in decreased claims and costs.

“When properly implemented as part of a systemwide quality improvement effort, such programs not only help foster a culture of transparency, and in doing so strengthen patients’ trust in the health care system, but also help to promote ongoing medical error prevention in a way that does not lead to increased medical liability,” they wrote.

Disclosure: Researcher James M. Scheiman, MD, FACG, has served as a consultant for AstraZeneca Pharmaceuticals POZEN, Stryker, McNeil Pharmaceuticals, Boehringer Ingelheim GmbH, Xlumena and Prostrakan.

Instituting a medical error disclosure program at one institution decreased gastroenterology-related claims, saved money in settlement dollars, claims-related costs and total liability, and shortened the period of time to resolving those claims, according to a recent study.

The study examined 66 claims — 38 before implementing a disclosure, apology and offer policy related to errors, and 28 after implementation — in 2001 at the University of Michigan Health System. Among claims, 15.2 % alleged delay in diagnosis or misdiagnosis, 42.4% were related to a procedure, and 42.4 % involved alleged improper management, treatment, or monitoring.

The pre-implementation claims came among 238,911 gastrointestinal (GI) encounters, while the remaining claims involved 411,944 GI cases — a reduction (P=.001) in the proportion of encounters resulting in a claim, with claim rates per 1,000 encounters dropping from 0.16% pre-implementation to 0.068% post-implementation.

The time to resolve claims was cut in half, from 1,000 days for pre-implementation claims to 460 days post-implementation (P<.0001).

Mean total liability fell by 52%, from $167,309 before implementation of the new program to $81,107 (95% CI, 33,682.5–300,936.2 for pre-implementation vs. 1,687.8–160,526.7 post-implementation). The difference was not considered significant because of sample size.

While the researchers noted their data were institution-specific and did not prove causality, they concluded that results confirmed disclosure, apology and offer programs can result in decreased claims and costs.

“When properly implemented as part of a systemwide quality improvement effort, such programs not only help foster a culture of transparency, and in doing so strengthen patients’ trust in the health care system, but also help to promote ongoing medical error prevention in a way that does not lead to increased medical liability,” they wrote.

Disclosure: Researcher James M. Scheiman, MD, FACG, has served as a consultant for AstraZeneca Pharmaceuticals POZEN, Stryker, McNeil Pharmaceuticals, Boehringer Ingelheim GmbH, Xlumena and Prostrakan.