Improving Neurosurgical Care in Egypt: A Questionnaire-Based Study of Neurosurgeons' and Patients' Perspectives on Risk Factors for Malpractice Claims.

Abstract

Neurosurgical procedures are associated with the highest rate of malpractice claims. We present this questionnaire-based study to evaluate the risk factors of neurosurgical malpractice claims in Egypt. We formulated two separate online questionnaires. A total of 950 Egyptian neurosurgeons were invited to participate in the first online questionnaire. A total of 1100 patients who had undergone neurosurgical operations (either spinal or cranial) were invited to participate in the second online questionnaire. Responses were received from 360 neurosurgeons, 69.4% of whom were at consultant or professor levels. In response to total income, 61.11% of our neurosurgeons reported a total income of > $ 200 (American dollar) per month. Regarding malpractice claims, 36.1% of neurosurgeons believe that malpractice claims are related mainly to spine surgeries. Death is considered the primary motivating surgical outcome for raising malpractice claims by 30.6% of our neurosurgeons, 61.1% of our neurosurgeons are practicing defensive medicine. Responses were also received from 380 neurosurgical patients, 83.3% of whom had spine surgery, seventy-five percent of patients underwent their surgery in private hospitals, 41.7% experienced complications. Regarding communications, 83.3% of patients reported satisfactory communication during their surgeries, and 86.1% were satisfied with their surgeries. Most Egyptian neurosurgeons prefer to practice defensive medicine because of the high number of malpractice claims. Very thorough measures and collaboration between the health systems, media, regulatory bodies, and neurosurgeons would be required to dismantle the complex situation and improve the practice at risk, and improve overall patient care.