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Number of public sector medical indemnity claims on the decline

29 January, 2009

The fifth annual report on public sector medical indemnity claims, released by the Australian Institute of Health and Welfare, shows the number of new public sector medical indemnity claims has fallen over the last four years.

While new claims increased from about 1,600 in 2003-04 to around 1,900 in 2005-06, they declined to around 1,300 in 2006-07.

'When adjusted for a one-off factor affecting one jurisdiction, new claims have declined over the last four years by about 15% per year,' said Belinda Emms, Head of the Institute's Health Care Safety and Quality Unit.

According to the report, Medical indemnity national data collection public sector 2006-07, medical or surgical procedures (36%) were the most commonly recorded primary reason for a claim, followed by diagnosis (23%) and treatment (16%).

'Examples of procedure allegations include failure to perform a procedure, having the wrong procedure performed or performed on the wrong part of the body, post-operative complications, or failure of a procedure,' Emms said.

'Diagnosis incidents could include a failure to diagnose or misdiagnosis, while examples of treatment issues could include delayed treatment, failure to provide treatment, or complications arising from treatment,' she said.

The three most frequent clinical contexts associated with medical indemnity claims were general surgery (18%), obstetrics (17%) and accident and emergency (15%).

This is the first year in which obstetrics claims were surpassed by general surgery claims.

Alleged harm to neuromusculoskeletal and movement-related functions and structures accounted for about 20% of claims.

In 13% of claims, the subject died allegedly as a result of the harm that gave rise to the claim.

Almost 70% of claims involved adults and 10% involved babies younger than 1 year of age.

Almost half of claims finalised during the year listed 'discontinued' as the reason for being finalised. For the other finalised claims, almost two-thirds were recorded as 'settled-other' which included those settled part way through a trial. The remaining fifth were settled through a state/territory complaints process.

Fewer than 5% of all finalised medical indemnity claims were finalised via a court decision.

Total claim size, including legal costs, was less than $100,000 for approximately 83% of finalised claims, and in excess of $500,000 for roughly 4% of finalised claims.

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