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Accountability Sought by Patients Following Adverse Events from Medical Care: The New Zealand Experience

The Issue

In New Zealand, patients who suffer medical injuries have two choices: if they seek monetary compensation, they may file claims with the Accident Compensation Corporation (ACC), which awards claims on a no-fault basis; if they seek accountability only, they may complain to the Health and Disability Commissioner (HDC).


What the Study Found

In comparing the experiences of patients who filed ACC claims with those who filed HDC complaints, this Commonwealth Fund–supported study found that:

  • The objectives of patients who sought legal action—either monetary or nonmonetary—can be categorized as communication, correction, restoration, or sanction.
  • The most common form of accountability among those seeking nonmonetary relief was a desire for corrective measures to address the causes of harm (50% of complainants). Forty percent of complainants were interested in communication, including information and transparency about what had happened.
  • Individuals who were in their prime working years (ages 30 to 64) or who had suffered a permanent disability were significantly more likely to seek compensation than older or younger patients, or who were less severely injured.


Conclusions

Because patients seeking accountability for medical injuries are often driven by a desire for corrective measures to address the causes of harm, they can be effective partners in efforts to make care safer. Complainants also want information and transparency about the causes of adverse events, indicating that health care institutions should make greater efforts to disclose and discuss medical errors. Nations like the United States, where litigation is the key route to accountability, offer few outlets for injured patients to obtain such information or corrective action.

Publication Details

Date

Citation

M. Bismark, E. Dauer, R. J. Paterson et al., "Accountability Sought by Patients Following Adverse Events from Medical Care: The New Zealand Experience," Canadian Medical Association Journal, Oct. 10, 1006 175(8):889–94.