Profile of the most common complaints for five health professions in Australia
Merrilyn Walton A , Patrick J. Kelly A F , E. Mary Chiarella B , Terry Carney C , Belinda Bennett D , Marie Nagy B and Suzanne Pierce EA Sydney School of Public Health, Sydney Medical School, University of Sydney, Edward Ford Building (A27), Camperdown, NSW 2006, Australia. Email: merrilyn.walton@sydney.edu.au
B Sydney School of Nursing and Midwifery, University of Sydney, 88 Mallett Street, Camperdown, NSW 2050, Australia. Email; mary.chiarella@sydney.edu.au; marie.nagy@sydney.edu.au
C Sydney Law School, University of Sydney, New Law School Building (F10), Camperdown, NSW 2006, Australia. Email: terry.carney@sydney.edu.au
D Faculty of Law, Queensland University of Technology, GPO Box 2434, Brisbane, Qld 4001, Australia. Email: belinda.bennett@qut.edu.au
E Office of the NSW Chief Scientist & Engineer, GPO Box 5477, Sydney, NSW 2001, Australia.Email: suzanne.pierce@chiefscientist.nsw.gov.au
F Corresponding author. Email: p.kelly@sydney.edu.au
Australian Health Review 44(1) 15-23 https://doi.org/10.1071/AH18074
Submitted: 17 April 2018 Accepted: 29 September 2018 Published: 29 October 2019
Journal Compilation © AHHA 2020 Open Access CC BY-NC-ND
Abstract
Objective The aims of this study were to profile the most common complaints and to examine whether any demographic factors are associated with receiving a complaint for five health professions in Australia.
Methods A national cohort study was conducted for all complaints received for medicine, nursing/midwifery, dentistry, pharmacy and psychology from 1 July 2012 to 31 December 2013 (18 months). Data were collected from the Australian Health Practitioner Regulation Agency (AHPRA), the New South Wales (NSW) Health Professional Councils’ Authority and the NSW Health Care Complaints Commission. The frequency and risk of complaints were summarised for the five professions and by demographic information.
Results There were 545 283 practitioners registered with AHPRA between 1 July 2012 and 31 December 2013, consisting of 20 935 dentists, 101 066 medical practitioners, 363 040 nurses/midwives, 28 370 pharmacists and 31 872 psychologists. During the study period there were 12 616 complaints, corresponding to an annual rate of 1.5 per 100 practitioners. Complaints were most common for doctors and dentists (5% per annum per practitioner) and least common for nurses/midwives (0.5% per annum per practitioner). Sex (P < 0.01), age (P < 0.01) and country of birth (P < 0.01) were all associated with risk of complaint. The most common complaints were clinical care (44% of all complaints), medication (10%) and health impairment of the practitioner (8%). Types of complaints varied by profession, sex and age.
Conclusions The risk of a complaint is low, but varies by profession and demographics. The types of complaints also vary by profession and demographics. Differences between professions is most likely driven by their different work tasks and work environments.
What is already known on this subject? Although complaints are summarised annually from state and national health regulators, no overall national summary of complaints across professions exists. Thus, it is difficult to examine which complaints are most common, how professions differ from each other or what factors may be associated with risk and type of complaint. Previous studies have primarily focused on a single profession, such as medicine, where, for example, the number of prior complaints, sex, doctor speciality and age have been found to be associated with recurrent complaints.
What does this paper add? This paper is the first of this kind to provide a national summary of all complaints from five of the most common health professions in Australia. We found that regardless of profession, men were at least twice as likely to have a complaint made against them than women. We also found that the types of complaint differed between men and women. There were similarities across professions for the most common types of complaints, but clear differences between professions were also noted. Not surprising, clinical care was typically the most common type of complaint for the five professions, but somewhat surprising was the inclusion of health impairment as one of the most common types of complaints.
What are the implications for practitioners? Identifying the most common complaints, and the factors associated with these, may assist practitioners to understand their risk(s) of complaint and could potentially assist educators and regulators develop education programs that help reduce complaints.
Additional keywords: governance, health law, health services, health services research, workforce.
References
[1] Francis JG. The politics of regulation: a comparative perspective. Oxford: Blackwell; 1993.[2] Australian Health Practitioner Regulation Agency. The national registration and accreditation scheme. 2017. Available at: http://www.ahpra.gov.au/About-AHPRA/What-We-Do.aspx [verified 14 February 2017].
[3] Dixon J. Regulating health care: the way forward. London: The King’s Fund; 2005.
[4] Professional Standards Authority (PSA). Rethinking regulation. London: PSA; 2015.
[5] Healy J. Improving health care safety and quality: reluctant regulators. Surrey: Ashgate; 2011.
[6] Dubois CA, Dixon A, McKee, M. Reshaping regulation of the workforce in European health care systems. In: Dubois CA, McKee M, Nolte E, editors. Human resources for health in Europe. Maidenhead: Open University Press; 2006. pp. 173–192.
[7] New South Wales, Royal Commission into Deep Sleep Therapy. Report of the Royal Commission into Deep Sleep Therapy. The Honourable Mr Acting Justice J.P. Slattery, Royal Commissioner. Syndey: NSW Government; 1990.
[8] Bismark MM, Spittal MJ, Gurrin LC, Ward M, Studdert DM. Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia. BMJ Qual Saf 2013; 22 532–40.
| Identification of doctors at risk of recurrent complaints: a national study of healthcare complaints in Australia.Crossref | GoogleScholarGoogle Scholar | 23576774PubMed |
[9] Australian Health Regulatory Agency (AHPRA). Annual report 2015/2016. Melbourne: AHPRA ; 2017.
[10] NSW Health Care Complaints Commission. Annual report 2015–2016. Sydney: NSW Health Care Complaints Commission; 2016.
[11] Health Professional Councils Authority (HPCA). Annual report 2015/16. Sydney: HPCA; 2016.
[12] Australian Institute of Health and Welfare. Workforce. 2016. Available at: http://www.aihw.gov.au/workforce/ [verified 20 May 2017].
[13] Zou G. Modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004; 159 702–6.
| Modified Poisson regression approach to prospective studies with binary data.Crossref | GoogleScholarGoogle Scholar | 15033648PubMed |
[14] Elkin K, Spittal MJ, Studdert DM. Risks of complaints and adverse disciplinary findings against international medical graduates in Victoria and Western Australia. Med J Aust 2012; 197 448–52.
| Risks of complaints and adverse disciplinary findings against international medical graduates in Victoria and Western Australia.Crossref | GoogleScholarGoogle Scholar | 23072241PubMed |
[15] Bismark MM, Spittal MJ, Studdert DM. Prevalence and characteristics of complaint-prone doctors in private practice Victoria. Med J Aust 2011; 195 25–8.
| 21728937PubMed |
[16] National Clinical Assessment Service (NCAS). Concerns about professional practice and associations with age, gender, place of qualifications and ethnicity – 2009–2010 data. London: NCAS; 2010.
[17] Bismark MM, Spittal MJ, Plueckhahn TM, Studdert DM. Mandatory reports of concerns about the health, performance and conduct of health practitioners. Med J Aust 2014; 201 399–403.
| Mandatory reports of concerns about the health, performance and conduct of health practitioners.Crossref | GoogleScholarGoogle Scholar | 25296061PubMed |
[18] Walton M, Smith-Merry J, Healy J, McDonald F. Health complaint commissions in Australia: time for a national approach to data collection. Aust Rev Public Affairs 2012; 11 1–8.
