SERIOUS MEDICAL ERRORS IN OBSTETRICS AND GYNECOLOGICAL PRACTICE IN BULGARIA - FREQUENCY OF PATIENT’S INJURY AND MORTALITY
Keywords:
Obstetrics and gynecology, medical error, bodily injury, deathAbstract
The present research aims to analyze the public information on inspections performed by the Executive Agency "Medical Supervision" (IAMS) of medical institutions in Bulgaria providing medical care in Obstetrics and Gynecology (OG), oncogynecology, neonatology and reproductive medicine for a period of three years (2014-2016) in order to establish the presence, frequency and causes of serious medical errors specifically - injuries or deaths of patients, as they receive the greatest public and media response, and have the greatest impact on the life, health and psyche of both patients and healthcare professionals. Materials and methods: The results of 264 inspections in 125 medical institutions were analyzed, as the main object of the study were 46 cases in which injuries of varying degrees or death were found. Results: In more than half of the cases of established medical error, it concerns a bodily injury of different severity or death. Among them, the largest share is of deaths - 55%, followed by severe injuries - 19.6%. The highest frequency of severe medical errors is observed in state hospitals - 46.2%. The highest percentage of deaths is in state hospitals also - 53.8%, followed by municipal hospitals - 38.5 % and it is only 7.7% in private ones. There is no statistically significant difference in the distribution of serious medical errors between the specialized OG hospitals, the multi-profile hospitals and the medical institutions for outpatient medical care, as well as between the different levels of competence of the medical institutions. The level of inflicted bodily injuries or deaths is statistically significantly higher when no "team selection" has been made. Conclusion: The study clearly highlights one major problem - the personal commitment of staff leads to the provision of higher quality medical services and in particular the minimization of the risk of injury or death. In this regard, future health policies should be focused on motivating medical staff and teams on one hand and on ensuring equal access for all health-insured patients to the highest level of medical care on the other.
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