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Decision-making on Patient Compensation Related to Adverse Events

ปัตพงษ์ เกษสมบูรณ์; บุศราพร เกษสมบูรณ์; ศุภสิทธิ์ พรรณารุโณทัย; อมร เปรมกมล; Pattapong Kessomboon; Nusaraporn Kessomboon; Supasit Pannarunothai; Amorn Premgamone;
Date: 2553-03
Abstract
Adverse events that occur in health service settings are resulting in more lawsuits than ever before. The new patient compensation bill is expected to resolve patient-provider conflicts. It will be designed to cover all groups of Thai people with acceptable claim process and amounts for compensations. This communication reports the results of a study on the decision-making processes involved in compensating injured patients under Article 41 of the National Health Security Act 2002.This was a descriptive study. The reasons used by committees in making decisions on whether to “pay“ or “not pay“ the agrieved parties under the provisions of Article 41 were analyzed and compared with the compensation criteria set out by the National Health Security Office. Altogether 1,276 claims made during the period 2003 - 2008 were included in the study. It was found that, of 1,276 claims, compensation was “paid out“ for 1,049 cases (82.2%) and 227 cases (17.8%) were “not paid”. The main reason for paying compensation was that “it was an unavoidable situation“ (76.5%). However, the reason above was not in accordance with the criteria for compensation. Only 27.1 percent of the claims were made in accordance with the criteria, stating that the injuries were related to medical errors or mistakes or substandard care. The main reason for not paying compensation was that “the adverse events were the results of disease processes“ (61.6%). This was in accordance with the criteria. The conclusion was that inconsistency and unclear decision-making on patient compensations existed. Of two cases with the same kind of injury, one might be paid and the other not. This type of situation might motivate patients to bring cases to court.
Copyright ผลงานวิชาการเหล่านี้เป็นลิขสิทธิ์ของสถาบันวิจัยระบบสาธารณสุข หากมีการนำไปใช้อ้างอิง โปรดอ้างถึงสถาบันวิจัยระบบสาธารณสุข ในฐานะเจ้าของลิขสิทธิ์ตามพระราชบัญญัติสงวนลิขสิทธิ์สำหรับการนำงานวิจัยไปใช้ประโยชน์ในเชิงพาณิชย์
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