The impact of malpractice liability claims on physician outcomes and practice patterns

• Main Author: Gimm, Gilbert W
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01.01.2005
• Subjects: Cesarean section; Clinical outcomes; Economics; Health care; Health care expenditures; Health care management; Health care policy; Insurance claims; Insurance coverage; Liability; Liability insurance; Medical errors; Medical malpractice; Medical practices; Negligence; Physicians; Studies; Torts
• ISBN: 9780542434969; 0542434962

Since the late 1960s, a dramatic rise in medical malpractice premiums has sparked both debate and concern among physicians and health policymakers. Much of the concern has focused on assertions that malpractice premiums and claims have risen to a point where physicians are now choosing to leave their practice or being forced to change. However, empirical evidence is limited to a few studies which rely on market-level variation, so the impact of claims on the individual response of physicians is not well understood. This dissertation examines whether malpractice claims have an impact on individual physician behavior, with respect to delivery volume, adverse outcome rates, C-section rates, and Medicaid patient mix. It also analyzes the factors that contribute to the likelihood of physician exit. Using a micro-level panel data set that links inpatient deliveries in Florida to malpractice claims from 1992-2000 with unique physician identifiers, I find strong evidence of a negative impact on volume. Physicians perform 6-10 fewer inpatient deliveries on average in response to the closing of a malpractice claim. Also, an incident occurrence is associated with a small improvement in the adverse outcome rate, and higher C-section rate among older physicians. Finally, physicians with a malpractice claim award of $500,000 or more have a significantly greater likelihood of exit from performing inpatient deliveries altogether.