A Questionnaire Based on A Sub-Regional Hierarchical Level Showed the Following: Application of Medical Accident Insurance is Suitable in Shanghai, China

Background: The application of medical accident insurance could not only cover parts of patients’ property loss caused by non-medical negligence, but also reduce the risks of medical staff during medical services. However, the compensation mechanism for medical accidents is unsound in china. Methods: In order to figure out the awareness and acceptance of the medical accident insurance in Shanghai medical institutions, medical staff and patients, a questionnaire survey was conducted. The feedback, which in total came from 22 medical institutions, 1,689 medical staff and 1,342 patients, was statistically analyzed by chi-square test.Results：Only 22.72% of the 22 hospitals in this questionnaire survey purchased medical accident insurance. As a result, medical accident insurance only accounts for 3.13% of medical compensation, which was far lower than the negotiated compensation ratio (61.25%) and the medical liability insurance compensation ratio (14.38%). This may be due to the low awareness of medical accident insurance, and our survey also proves this phenomenon. In this survey, we find that only a small proportion (22.73%) of medical institutions purchase medical accident insurance. What is more unexpected is that the vast majorities of patients (50.00%) and medical workers (64.00%) have only heard of it and are not aware of it. Although nearly half of the patients (45.16%) and medical workers (58.26%) are willing to buy medical accident insurance, there were still some patients and medical workers who were uncertain (32.80% and 38.82%, respectively) or unwilling to buy it (8.94% and 16.02%, respectively). The reason is nothing more than that no benefits will occur while the cost is high. Among those willing to buy, the majority of the patients (58.19%) and medical workers (54.39%) only accept the amount of insurance less than RMB 200 yuan. Conclusions: The acceptability and cognition of medical accident insurance in medical workers and patients are still at a low level in Shanghai. In addition, preliminary data from medical institutions purchasing medical accident insurance shows that the insurance can effectively reduce medical disputes and ease economic burden. To sum up, medical accident insurance has good application prospect and space in Shanghai, China.

Complex Insurance of Risks of Professional Medical Liability

The article considers the relevance of the risk of professional responsibility in medical activities. Russian healthcare is still on the periphery of risk management studies, and most studies include only different approaches to classifying the risks of medical organizations. Despite the growing threat of prosecution for medical error, the use of insurance tools to protect the medical community has not yet been widely implemented. Based on the analysis of the existing practice of medical liability insurance in Russia and abroad, we offer individual liability insurance for medical workers. The complex model of risk insurance of medical organizations and medical workers is substantiated.

Duty of treatment and duty of care, and scope of insurance coverage in medical liability insurance

The subject of this publication is the duty of treatment and the duty of care, a breach of which may lead to civil liability of a physician. These duties are considered from the point of view of their scope, meaning for the responsible entity and for the insurer under civil liability insurance. The duty of care is no less important. It applies to the entire diagnostic and therapeutic process, both to the action and omission of a physician, individual medical procedures, the use of current medical knowledge, the use of medical devices or medicinal products. The point is to exercise care and diligence required of a professional (art. 355 § 2 of the [Polish] Civil Code). There is no doubt that a breach of the dutyof treatment or the duty of care falls under the scope of insurance cover in civil liability insurance. The problem arises,however, when a certain action or omission of the doctor leads to an infringement of the patient's right, but no personal injury occurs.Then, it has not been clearly resolved whether the mere breach of the obligation of treatment leads to the liability of the civil liability insurer. This issue is gaining more and more practical meaning.

Medical liability insurance claims after treatment of varicose veins

Objective: Since insight into the reason for filing claims after treatment of varicose veins of the lower extremity might help prevent future claims, we determined the incidence of and reasons for medical liability insurance claims after such treatments in the Netherlands. Method: We performed a retrospective review of all medical liability insurance claims after varicose vein treatment handled by MediRisk between January 1993 and December 2007. Results: A total of 144 claims were filed of which 104 were closed by the end of the study period. Nerve injury ( n = 28), skin necrosis following sclerotherapy ( n = 17), deep vein injury ( n = 11) and insufficient communication ( n = 9) accounted for more than 60% of all claims. Claims were equally distributed among registrars and consultants. Some 41 of the 104 closed claims were accepted. In 27 of the accepted cases, the physician had obviously failed in providing the care as expected from a medical practitioner allowed to perform these treatments. The majority of these 27 claims were due to injury of nerves ( n = 11) or deep veins ( n = 9). Conclusion: The incidence of claims after treatment of varicose veins in the Netherlands is low. Proper knowledge of anatomy and adequate communication, along with the introduction of less invasive treatments might prevent future claims.