Abstract
The Act for Patient Injuries came into force on May 1987 in Finland. This Act covers all medical treatment, both public and private care in Finland including examination, surgical and non-operative treatment, physiotherapy, rehabilitation as well as patient transportation. The Finnish Patient Insurance Centre handles all claims in Finland, about 6.000 cases yearly, of which about 1.700 will give compensation to the patients. So far, operative treatment in orthopaedics and traumatology has produced most injuries. The Centre is supervised by an independent Patient Injury Board stated by the Ministry of Health. The injuries are divided into three subgroups: 1. treatment injuries, 2. injuries caused by infection and 3. true traumatic accidents. In addition, there is a special pool for medicine induced side effects or injuries which is organized in cooperation with pharmaceutical companies selling drugs in Finland.
All evaluation of each individual case is based on probability. If there is more than 50% probability between the suspected treatment phase and injury the precondition for compensation is present.
Moreover, the evaluation is concentrated to the case itself and the personnel involved will not be accused or sued whenever a patient injury has been recognised. This no-guilt principle has guaranteed that most of the injuries have been reached and evaluated by the Patient Insurance Centre. All the 18 hospital districts in Finland covering both common health services and hospital care have their own policyholder status. Total expenses, both compensation and administrative, will be charged from the districts with a non-profit principle. Private hospitals and smaller units have their own contracts with insurance companies, and medical and dental unions have contracts of their own for individually working physicians and dentists.
The prerequisite for compensation is that there has to be an objectively recognised and measurable harm to the patient due to a diagnostic or treatment procedure. In the treatment injuries the level of acceptable care is determined by standard of an experienced professional of that speciality he/she represents. That means e.g., that an orthopaedic operative or diagnostic procedure will be evaluated compared to the level which a graduated and experienced orthopaedic surgeon could have normally reached. Infection injuries are considered acceptable when being superficial, or if a deep infection heels within a couple of weeks or months with adequate treatment and without any permanent disability. Traumatic accidents are quite rare. These are for example all injuries caused by broken medical equipment, falling of the patient during examination or treatment etc. However, it does not cover falling of the patients if this occurs during the hospital stay while no medical treatment is given.
The yearly claim and compensation data is used for comparative analysis between the hospital districts and given also to the medical and surgical societies in order to enhance medical knowledge and skills and prevention of similar injuries in the future.
Theses abstracts were prepared by Professor Dr. Frantz Langlais. Correspondence should be addressed to him at EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
