Characteristics of medical malpractice claims over 22 years: a population-based analysis in Catalonia, Spain.

BACKGROUND

Data on malpractice claims provide crucial healthcare-related information to stakeholders: policymakers, insurance companies, patients, and the society in general. Population-based studies on professional liability claims are scarce.

OBJECTIVE

To assess the characteristics of medical malpractice claims over 22 years in Catalonia, Spain, covering a descriptive period (2000-2022) and a population-based trend analysis period (2000-2018).

METHODS

Retrospective longitudinal analysis of malpractice claims records obtained from insurance policies established through the jointly coordinated risk-coverage agreement between the Council of Medical Associations of Catalonia (CCMC) and the public health administration, via the Catalan Health Service (CatSalut). Changes in population-based malpractice claims overall and regarding hospitalisation, surgery, obstetrics, and emergency care were assessed. Claim rates by activity type were calculated and trends assessed using linear regression and the Kolmogorov-Smirnov test for time-delay distribution.

RESULTS

While Catalonia's population showed a 22.3% increase (2000-2018), total medical malpractice claims decreased by 9.5% and population-adjusted claim rates (2000-2018) dropped by 26.1% (P < 0.0005). Surgical claim rates fell by 34.0%, obstetric claims by 3.7%, and emergency-related claims by 20.5%. Hospitalization-related rates remained stable. The mean delay between the incident and claim filing was 23.9 months.

CONCLUSIONS

In contrast to the general perception, medical malpractice claims in Catalonia have declined or stabilized over the past two decades especially when adjusted for healthcare activity. The Catalan insurance model enables robust population-level data, providing a unique tool for medicolegal risk monitoring. These findings support the use of standardized population-based parameters and argue for international comparison of health management models to inform policy and enhance patient safety.