The Application of Graph Theoretical Analysis to Complex Networks in Medical Malpractice in China: Qualitative Study

Shengjie Dong; Chenshu Shi; Wu Zeng; Zhiying Jia; Minye Dong; Yuyin Xiao; Guohong Li

doi:10.2196/35709

The Application of Graph Theoretical Analysis to Complex Networks in Medical Malpractice in China: Qualitative Study

JMIR Med Inform. 2022 Nov 3;10(11):e35709. doi: 10.2196/35709.

Authors

Shengjie Dong^{1

2}, Chenshu Shi³, Wu Zeng⁴, Zhiying Jia^{1

5}, Minye Dong¹, Yuyin Xiao¹, Guohong Li^{1

6}

Affiliations

¹ School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
² Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, China.
³ Center for Health Technology Assessment, China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.
⁴ Department of International Health, Georgetown University, Washington, DC, United States.
⁵ Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
⁶ China Hospital Development Institute, Shanghai Jiao Tong University, Shanghai, China.

PMID: 36326815
PMCID: PMC9673000
DOI: 10.2196/35709

Abstract

Background: Studies have shown that hospitals or physicians with multiple malpractice claims are more likely to be involved in new claims. This finding indicates that medical malpractice may be clustered by institutions.

Objective: We aimed to identify the underlying mechanisms of medical malpractice that, in the long term, may contribute to developing interventions to reduce future claims and patient harm.

Methods: This study extracted the semantic network in 6610 medical litigation records (unstructured data) obtained from a public judicial database in China. They represented the most serious cases of malpractice in the country. The medical malpractice network of China was presented as a knowledge graph based on the complex network theory; it uses the International Classification of Patient Safety from the World Health Organization as a reference.

Results: We found that the medical malpractice network of China was a scale-free network-the occurrence of medical malpractice in litigation cases was not random, but traceable. The results of the hub nodes revealed that orthopedics, obstetrics and gynecology, and the emergency department were the 3 most frequent specialties that incurred malpractice; inadequate informed consent work constituted the most errors. Nontechnical errors (eg, inadequate informed consent) showed a higher centrality than technical errors.

Conclusions: Hospitals and medical boards could apply our approach to detect hub nodes that are likely to benefit from interventions; doing so could effectively control medical risks.

Keywords: complex network; health systems; hub nodes; medical malpractice; patient safety management; scale-free network.

©Shengjie Dong, Chenshu Shi, Wu Zeng, Zhiying Jia, Minye Dong, Yuyin Xiao, Guohong Li. Originally published in JMIR Medical Informatics (https://medinform.jmir.org), 03.11.2022.