Article

"Health courts" and accountability for patient safety.

Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA.
Milbank Quarterly (Impact Factor: 4.64). 02/2006; 84(3):459-92. DOI: 10.1111/j.1468-0009.2006.00455.x
Source: PubMed

ABSTRACT Proposals that medical malpractice claims be removed from the tort system and processed in an alternative system, known as administrative compensation or "health courts," attract considerable policy interest during malpractice "crises," including the current one. This article describes current proposals for the design of a health court system and the system's advantages for improving patient safety. Among these advantages are the cultivation of a culture of transparency regarding medical errors and the creation of mechanisms to gather and analyze data on medical injuries. The article discusses the experiences of foreign countries with administrative compensation systems for medical injury, including their use of claims data for research on patient safety; choices regarding the compensation system's relationship to physician disciplinary processes; and the proposed system's possible limitations.

0 Bookmarks
 · 
107 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Medical mistakes are often referred to as the "hidden epidemic" of health because doctors, patients, and hospital administrators remain silent about mistakes. This study relies on in-depth interviews to explore how physicians story their medical mistake experiences. Narrative theory is used to understand how these physicians story the complexity of medical mistakes, highlighting how these physicians bear witness to medical mistakes by sharing and listening to medical mistake narratives. Moreover, this study showcases the implications of how practitioners and scholars bear witness to the oft-times emotional telling and retelling of health narratives.
    Health Communication 07/2010; 25(5):449-58. · 0.97 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Evaluating the success of adjudicative tribunals is an important but elusive undertaking. Adjudicative tribunals are created by governments and given statutory authority by legislatures for a host of reasons. These reasons may and often do include legal aspects, policy aspects and partisan aspects. While such tribunals are increasingly being asked by governments to be accountable, too often this devolves into publishing statistics on their caseload, dispositions, budgets and staffing. We are interested in a different and more basic question - are these tribunals successful? How do we know, for example, whether the remedies ordered by a tribunal actually do advance the purposes for which it was created? Can the success of an adjudicative tribunal be subject to meaningful empirical validation? While issues of evaluation and accountability cut across national and jurisdictional boundaries, the authors argue that this type of question can only be addressed empirically, by actually looking to the practice of a particular board or boards, in the context of a particular statute or statutes, and in particular jurisdictions at particular times. Such accounts can and should form the basis for comparative study. Only through comparative study can the value and limitations of particular methodologies become apparent. This study takes as its case study the role of adjudicative tribunals in the health system. The authors draw primarily from Canadian tribunal experience, though examples from other jurisdictions are used to demonstrate the potential of empirical evaluation. The authors discuss the relative dearth of empirical study in administrative law and argue that it ought to be the focus of the discussion on accountability in administrative justice.
    01/2010;
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Periods in which the costs of personal injury litigation and liability insurance have risen dramatically have often provoked calls for reform of the tort system, and medical malpractice is no exception. One proposal for fundamental reform made during several of these volatile periods has been to relocate personal injury disputes from the tort system to an alternative, administrative forum. In the medical injury realm, a leading incarnation of such proposals in recent years has been the idea of establishing specialized administrative "health courts." Despite considerable stakeholder and policy-maker interest, administrative compensation proposals have tended to struggle for broad political acceptance. In this article, we consider the historical experience of administrative medical injury compensation proposals, particularly in light of comparative examples in the context of workplace injuries, automobile injuries, and vaccine injuries. We conclude by examining conditions that may facilitate or impede progress toward establishing demonstration projects of health courts.
    Journal of Health Politics Policy and Law 09/2008; 33(4):725-60. · 1.24 Impact Factor

Full-text

View
3 Downloads
Available from