Defensive Medicine and Obstetric Practices
In: Journal of Empirical Legal Studies, Forthcoming
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In: Journal of Empirical Legal Studies, Forthcoming
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In: Regulation: the Cato review of business and government, Band 28, Heft 3, S. 24-31
ISSN: 0147-0590
Explores four questions regarding the impact of medical malpractice liability costs by analyzing data from a variety of sources. Examined are differences between states and overtime in malpractice payments and premiums, the physician workforce, use of and spending on medical procedures, and health insurance premiums. Findings indicate that indirect and anecdotal evidence on the effects may be misleading. Increases in malpractice payments do not seem to be driving premium increases. Increases in malpractice costs do not seem to affect the overall size of the physician workforce, although they may affect some subsets of the population more severely. The strongest effect of greater malpractice pressures is found in the increases use of imaging services, but little evidence is found of increased use of major surgical procedures. It is concluded that state-level tort reform is unlikely to affect medicine by averting local physician shortages.
In: Journal of Empirical Legal Studies, Band 9, Heft 3, S. 457-481
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In: NBER Working Paper No. w24846
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Working paper
In: Journal of the Nepal Health Research Council, Band 16, Heft 41, S. 483-485
ISSN: 1999-6217
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In: Evaluation and Program Planning, Band 7, Heft 1, S. 95-104
In: Medical care research and review, Band 54, Heft 4, S. 456-471
ISSN: 1552-6801
To describe the malpractice environment as it relates to defensive medicine, the authors studied omission-related claims from a large physician-owned malpractice insurer covering 70 percent of physicians in a northeastern state. During a 12-year period (1977-1989), claims resulting from alleged diagnostic omissions were considered important in less than 9 percent of claims and of central importance in 4 percent. Compared with other claim types, omission-related claims were more likely to be paid, had a higher median payment, and were more often associated with significant patient injury or death; the association with more frequent payments remained after controlling for physician specialty, geographic region, and degree of patient injury. Malpractice claims alleging diagnostic and monitoring omissions are relatively uncommon but appear difficult to defend relative to other claim types. Taken in light of the changing health care environment, these results highlight the limits of defensive medicine and support an expanded focus for medical liability reform.
In: Eastern economic journal: EEJ, Band 34, Heft 2, S. 141-157
ISSN: 1939-4632
In: Dynamic games and applications: DGA, Band 12, Heft 4, S. 1067-1085
ISSN: 2153-0793
AbstractWe analyze different scenarios of defensive medicine in a novel framework based on game theory and network analysis, where links in the network represent healing relationships between a physician and a patient. The physician should choose between providing the optimal treatment or an inferior one, which can amount to practicing defensive medicine. The patient should choose whether to litigate or not if an adverse event occurs. A major result of such analysis is that the steady state does not depend on the litigiousness of the initial system or the initial distribution of strategies among physicians or the distribution of patients over physicians. Moreover, reaching a virtuous steady state or an entirely defensive one appears to be independent of the fact that patients take into account the quality of treatments directly or they rely merely on popularity when choosing their physicians.
In: Northwestern Law & Econ Research Paper
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In: Journal of Empirical Legal Studies, Band 16, Heft 1, S. 26-68
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We estimate the extent of defensive medicine by physicians during labor and delivery, drawing on a novel and significant source of variation in liability pressure. In particular, we embrace the no-liability counterfactual made possible by the structure of liability rules in the Military Heath System. Active-duty patients seeking treatment from military facilities cannot sue for harms resulting from negligent care, while protections are provided to dependents treated at military facilities and to all patients—active-duty or not—who receive care from civilian facilities. Drawing on this variation and addressing endogeneity in the choice of treatment location by estimating mother fixed effects specifications and by exploiting exogenous shocks to care location choices stemming from base-hospital closures, we find suggestive evidence that liability immunity increases cesarean utilization and treatment intensity during childbirth, with no measurable negative effect on patient outcomes.
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In: Journal of Empirical Legal Studies, Band 17, Heft 1, S. 4-37
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In: Baungaard , N , Skovvang , P , Assing Hvidt , E , Gerbild , H , Kirstine Andersen , M & Lykkegaard , J 2020 , ' How defensive medicine is defined and understood in European medical literature : Protocol for a systematic review ' , BMJ Open , vol. 10 , no. 2 , e034300 . https://doi.org/10.1136/bmjopen-2019-034300
Introduction The term defensive medicine, referring to actions motivated primarily by litigious concerns, originates from the USA and has been used in medical research literature since the late 1960s. Differences in medical legal systems between the US and most European countries with no tort legislation raise the question whether the US definition of defensive medicine holds true in Europe. Aim To present the protocol of a systematic review investigating variations in definitions and understandings of the term € defensive medicine' in European research articles. Methods and analysis In concordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of all medical research literature that investigate defensive medicine will be performed by two independent reviewers. The databases PubMed, Embase and Cochrane will be systematically searched on the basis of predetermined criteria. Data from all included European studies will systematically be extracted including the studies' definitions and understandings of defensive medicine, especially the motives for doing medical actions that the study regards as € defensive'. Ethics and dissemination No ethics clearance is required as no primary data will be collected. The results of the systematic review will be published in a peer-reviewed, international journal. PROSPERO registration number This review has been submitted to International Prospective Register of Systematic Reviews (PROSPERO) and is awaiting registration.
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