Legal regulation of health care management based on forensic medical assessment of early in-hospital mortality.

Abstract

Objective: Aim: To analyze the legal regulation of health care management based on the analysis of forensic medical examinations concerning the quality of medical care in cases of early in-hospital mortality.

Patients and methods: Materials and Methods: A retrospective forensic medical examination was conducted of 51 cases of patient mortality occurring within the first 24 hours after hospital admission in a multidisciplinary hospital in Kyiv. Organizational and legal aspects of medical care delivery were analyzed for compliance with legislation and clinical protocols.

Results: Results: Systemic deficiencies included the absence of electrocardiographic examination in 90,2 ± 4,2% of cases, regardless of diagnostic accuracy. Significant trends were identified as the hospital stay duration increased: the absence of oxygen therapy showed a downward trend (from 86,7 ± 8,8% to 38,5 ± 13,5%; ptrend = 0,006), while diagnostic discrepancies demonstrated an upward trend (from 6,7 ± 6,4% to 46,2 ± 13,8%; ptrend = 0,016). The median number of deficiencies doubled from 2 (1-3) in the <3 h group to 4 (3-4) in the 12-24 h group (p = 0,002). A moderate direct correlation was established between patient age and the total number of deficiencies (ρ = 0,462; p < 0,001).

Conclusion: Conclusions: The identified deficiencies correlate with non-compliance with mandatory regulatory requirements. The accumulation of medical errors with increasing length of stay and patient age indicates systemic violations of organizational and legal standards, necessitating stricter public administration control over medical care quality.