Assessing medical misconduct and complaints in Iranian health system: A systematic review of the literature

We aimed to assess available evidence about medical misconducts and complaints in Iranian health system. We used systematic review methodology. We systematically searched four national databases and hand-searched three relevant journals. After quality appraisal, data was extracted from the literature and analyzed using qualitative synthesis approach. We retrieved 50 relevant reports and articles. They were classified into 3 categories: Medical negligence (26 reports), medical crimes (6 reports) and health care frauds and abuses (18 reports). Most of the papers in the first category focused on the results of complaints registered for litigation and few focused on their context or causes. We didn’t find any primary data in the majority of articles in the second and third categories. There was no estimation of the quantity, severity, or the effects of any of the misconduct and complaint categories. Conclusios: Studies only focused on some elements of the problem and rarely on process-related or systematic causes of misconduct. Studies that focused on medical criminal offences did not discuss potential legal limitations. Despite considerable financial impacts of healthcare fraud and abuse, this aspect of the problem had received even less attention.