Improving the physician-patient relationship through timely caring services in Taiwan's no-fault childbirth compensation system

Malpractice pressure in obstetrics contributes to clinician burnout, defensive practice, and declining participation in high-risk maternity care. Taiwan's Childbirth Accident Emergency Relief Act (CAERA) integrates a national no-fault compensation system with mandated caring services, including early communication, emotional support, and administrative assistance after childbirth-related adverse events. This study is to evaluate the timeliness, content, and perceived effectiveness of caring services under CAERA and their association with patient satisfaction and physician-patient relationships.

This cross-sectional study analyzed nationwide survey data from compensated families and medical institutions following childbirth-related adverse events. Perceptions of caring service timing and content were compared between patients and providers. Associations between service timeliness and satisfaction outcomes were examined using standard statistical methods.

A total of 1345 family and 1074 institutional responses were analyzed. Substantial perception gaps were identified. Only 38.6% of families reported receiving caring services within 2 days, compared with 82.4% of institutions. Families also reported lower rates of communication (44.0% vs 81.4%), procedural assistance (69.7% vs 93.6%), and emotional support (62.2% vs 95.0%) than providers reported delivering (all P < 0.05). Timeliness was strongly associated with outcomes: families contacted within 2 days reported significantly higher satisfaction with the compensation process, administrative procedures, and physician-patient relationships than those contacted later (all P < 0.05).

Substantial gaps exist between provider-reported and patient-perceived caring services. Early engagement is associated with higher satisfaction and stronger physician-patient relationships. These findings suggest that the success of no-fault systems depends not only on financial compensation but also on prompt caring services.