Malpractice Claims and Incident Reporting: Two Faces of the Same Coin?

Area of Science:

• Healthcare Quality and Safety
• Risk Management in Medicine
• Patient Harm Analysis

Background:

• Incident reporting systems are vital for identifying risks and driving healthcare improvements.
• Medical malpractice claims analysis is a critical tool for understanding patient harm.
• Both systems capture patient damage, but incident reports also include near misses and no-harm events.

Purpose of the Study:

• To compare medical malpractice claims with incident reporting data to assess their similarities and differences.
• To evaluate the overlap and divergence between reported incidents and actual claims.
• To understand the scope of patient safety events captured by each system.

Main Methods:

• Analysis of 843 malpractice claims (2014-2021) and 1919 incident reports (2020-2021) from Policlinico Universitario A. Gemelli IRCCS.
• Utilized Incurred But Not Reported (IBNR) calculation to assess the true number of adverse events.
• Compared quarterly distributions of damage events from claims versus adverse and sentinel events from incident reports (2020-2021).

Main Results:

• Incurred But Not Reported (IBNR) events were found to be practically irrelevant, with reported adverse events closely matching total events.
• Malpractice claims showed a slightly decreasing trend (2020-2021).
• Incident reports demonstrated an increasing trend during the same period (2020-2021).

Conclusions:

• A significant divergence exists between medical malpractice claims and incident reporting data, with limited overlap.
• Incident reporting captures a wider spectrum of patient safety events than claims alone.
• Further research into specific types of adverse events is recommended to refine understanding and improve patient safety.