[Analysis of patient complaints in Primary Care: An opportunity to improve clinical safety]

Abstract

Objective: To determine the prevalence and type of the clinical safety problems contained in the complaints made by patients and users in Primary Care.

Material and methods: An observational, descriptive, cross-sectional study was conducted by analysing both the complaint forms and the responses given to them in the period of one year.

Results: At least 4.6% of all claims analysed in this study contained clinical safety problems. The family physician is the professional who received the majority of the complaints (53.6%), and the main reason was the problems related to diagnosis (43%), mainly the delay in diagnosis. Other variables analysed were the severity of adverse events experienced by patients (in 68% of cases the patient suffered some harm), the subsequent impact on patient care, which was affected in 39% of cases (7% of cases even requiring hospital admission), and the level of preventability of adverse events (96% avoidable) described in the claims. Finally the type of response issued to each complaint was analysed, being purely bureaucratic in 64% of all cases.

Conclusions: Complaints are a valuable source of information about the deficiencies identified by patients and healthcare users. There is considerable scope for improvement in the analysis and management of claims in general, and those containing clinical safety issues in particular. To date, in our area, there is a lack of appropriate procedures for processing these claims. Likewise, we believe that other pathways or channels should be opened to enable communication by patients and healthcare users.

Keywords: Atención Primaria de Salud; Calidad de la atención sanitaria; Claims; Patient safety; Primary Health Care; Quality of health care; Reclamaciones; Seguridad del paciente.