{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T15:00:09Z","timestamp":1767193209833,"version":"3.48.0"},"reference-count":35,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T00:00:00Z","timestamp":1755993600000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,7,24]]},"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To analyse patient complaints from an early-stage hospital in South Korea using the Healthcare Complaints Analysis Tool, identify harm patterns across care stages and provide insights for resource allocation and risk management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective analysis of patient complaints (22 March 2022\u201328 June 2024).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A newly established general hospital with approximately 700 beds in the metropolitan area of Gyeonggi-do, South Korea, which was established during the COVID-19 pandemic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 1113 patient complaints comprising 1952 discrete complaint issues were collected, with submissions originating from patients themselves (64%), family members or friends (21%) and individuals with unclear relationships to patients (15%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Primary outcome measures comprised occurrence and severity of patient harm. Secondary outcome measures included distribution of complaints across clinical, management and relationship domains, and identification of healthcare stages with concentrated harm using hotspot analysis and logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the complaints, 78% did not result in harm. Among those that did, 52%, 40% and 7% were of low, moderate and high severity, respectively. Hotspot analysis indicated that harm was concentrated during diagnosis (stage 2), ward care (stage 3) and operation\/procedure (stage 4) stages, with stage 4 exhibiting the highest Pearson residual value of 9.56. Logistic regression indicated that clinical domain complaints had the strongest association with patient harm (OR=32.25, 95% CI=20.88 to 51.01, p&lt;0.001), while the operation\/procedure stage exhibited the highest stage-specific risk (OR=30.62, 95% CI=9.80 to 93.93, p&lt;0.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study highlighted the critical care stages in which harm was concentrated, emphasising the need for proactive risk management particularly during operations and procedures. The findings provide valuable insights into resource allocation and underscore the importance of patient complaints in improving healthcare quality and safety across healthcare institutions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-102802","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T01:45:36Z","timestamp":1756086336000},"page":"e102802","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Stage-specific harm in early-stage hospitals in South Korea: a retrospective analysis using the healthcare complaints analysis tool"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3848-7259","authenticated-orcid":false,"given":"Young Gyu","family":"Kwon","sequence":"first","affiliation":[{"name":"Center for Chung-Ang Medical Education Resource Allocation (CAMERA), College of Medicine, Chung-Ang University, Dongjak-gu, Seoul, 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Chol","family":"Choi","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy and Critical Care Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Republic of Korea"},{"name":"Department of Internal Medicine, College of Medicine, Chung-Ang University, Dongjak-gu, Seoul, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daun","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, College of Medicine, Chung-Ang University, Dongjak-gu, Seoul, Republic of Korea"},{"name":"Division of Critical Care Medicine, Department of Emergency Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong-si, Gyeonggi-do, Republic of Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chan Woong","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Chung-Ang Medical Education Resource Allocation (CAMERA), College of Medicine, 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