Legal regulation of health care management based on forensic medical assessment of early in-hospital mortality
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1
BOGOMOLETS NATIONAL MEDICAL UNIVERSITY, KYIV, UKRAINE
2
TARAS SHEVCHENKO NATIONAL UNIVERSITY OF KYIV, KYIV, UKRAINE
3
KYIV UNIVERSITY OF INTELLECTUAL PROPERTY AND LAW, KYIV, UKRAINE
Publication date: 2026-02-27
Wiadomości Lekarskie 2026;(2):355-361
KEYWORDS
ABSTRACT
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.
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: Systemic deficiencies included the absence of electrocardiographic examination in 90,2 ± 4,2% of cases, regardless of diagnostic accuracy. Significan
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%;
= 0,006), while diagnostic discrepancies demonstrated an upward trend (from 6,7 ± 6,4% to 46,2 ± 13,8%; p
= 0,016). The median number of defi
ptrend
ptrend
ciencies
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 (. = 0,462; p < 0,001).
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.