Does Tort Law Improve the Health of Newborns, or Miscarry? A Longitudinal Analysis of the Effect of Liability Pressure on Birth Outcomes

Yang, Y. Tony; Studdert, David M.; Subramanian, S. V.; Mello, Michelle M.

doi:10.1111/j.1740-1461.2012.01252.x

Cited by 22 publications

(22 citation statements)

References 76 publications

(135 reference statements)

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“…The original attempts by HMPS investigators to find a relationship were inconclusive. (5, 10) A later, more sophisticated re-analysis of the data found a negative association between the number of claims against hospitals and their subsequent adverse event rates, but none of the other outcome-exposure combinations tested showed significant relationships. (5) One weakness of the HMPS deterrence analyses was that the main quality measure used, hospital adverse event rates, was cross-sectional, because it was obtained during a single medical record review.…”

Section: Discussionmentioning

confidence: 99%

“…More problematic was the misalignment between the litigation and quality measures: the HMPS analyses linked litigation brought against physicians working in the hospitals to hospital-level quality indicators. (10) A third study by Troyer and colleagues assessed the impact of claims against nursing homes on inspection-related quality measures, finding a modestly negative impact of claims on quality. (25) However, these analyses were largely exploratory in nature, included only 48 malpractice claims, and focused on a single state (Florida) for the time period 1993–1997.…”

Section: Discussionmentioning

confidence: 99%

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Does Litigation Increase or Decrease Health Care Quality?

Stevenson

Spittal²,

Studdert³

2013

Medical Care

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Background The tort system is supposed to help improve the quality and safety of health care, but whether it actually does so is controversial. Most previous studies modeling the effect of negligence litigation on quality of care are ecologic. Objective To assess whether the experience of being sued and incurring litigation costs affects the quality of care subsequently delivered in nursing homes. Research Design, Subjects, Measures We linked information on 6,471 negligence claims brought against 1,514 nursing homes between 1998 and 2010 to indicators of nursing home quality drawn from two U.S. national datasets (Online Survey, Certification, and Reporting system; Minimum Data Set Quality Measure/Indicator Reports). At the facility level, we tested for associations between 9 quality measures and 3 variables indicating the nursing homes’ litigation experience in the preceding 12–18 months (total indemnity payments; total indemnity payments plus administrative costs; ≥1 paid claims vs. none). The analyses adjusted for quality at baseline, case-mix, ownership, occupancy, year, and facility and state random effects. Results Nearly all combinations of the 3 litigation exposure measures and 9 quality measures—27 models in all—showed an inverse relationship between litigation costs and quality. However only a few of these associations were statistically significant, and the effect sizes were very small. For example, a doubling of indemnity payments was associated with a 1.1% increase in the number of deficiencies and a 2.2% increase in pressure ulcer rates. Conclusions Tort litigation does not increase the quality performance of nursing homes, and may decrease it slightly.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Does Litigation Increase or Decrease Health Care Quality?

Stevenson

Spittal²,

Studdert³

2013

Medical Care

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“…It tested the following hypothesis: in those US states with stricter rules on medical malpractice, newborns should be in better health. The study did not find a significant association between the two (Yang et al 2012). …”

Section: Competing Methodologies A) Choice Of Methodsmentioning

confidence: 59%

Behavioral Law and Economics: Empirical Methods

Engel

2013

SSRN Journal

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“…12,16,[27][28][29][30]32,[34][35][36]38,40,[42][43][44][45][46] Twelve studies evaluated the impact of tort reform on defensive medicine by assessing health care utilization 20,22,23,25,26,28,37,38,47,49,51,52 of which two (17 percent) used a difference-in-differences specification. 28,38 Thirteen studies studied quality of care 16,20,21,26,28,29,[33][34][35]37,41,48,54 of which five (38 percent) used a difference-in-differences specification. 16,28,29,34,35 Health care spending was evaluated by eight studies…”

Section: Study Characteristicsmentioning

confidence: 99%

The impact of tort reform on defensive medicine, quality of care, and physician supply: A systematic review

Agarwal¹,

Gupta²,

Gupta

2019

Health Services Research

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Objective To evaluate the impact of tort reform on defensive medicine, quality of care, and physician supply. Data Sources Empirical, peer‐reviewed English‐language studies in the MEDLINE and HeinOnline databases that evaluated the association between tort reform and our study outcomes. Study Design We performed a systematic review in accordance with the PRISMA guidelines. Data Collection/Extraction Methods Title and abstract screening was followed by full‐text screening of relevant citations. We created evidence tables, grouped studies by outcome, and qualitatively compared the findings of included studies. We assigned a higher rating to study designs that controlled for unobservable sources of confounding. Principal Findings Thirty‐seven studies met screening criteria. Caps on damages, collateral‐source rule reform, and joint‐and‐several liability reform were the most common types of tort reform evaluated in the included studies. We found that caps on noneconomic damages were associated with a decrease in defensive medicine, increase in physician supply, and decrease in health care spending, but had no effect on quality of care. Other reform approaches did not have a clear or consistent impact on study outcomes. Conclusions We conclude that traditional tort reform methods may not be sufficient for health reform and policy makers should evaluate and incorporate newer approaches.

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Does Tort Law Improve the Health of Newborns, or Miscarry? A Longitudinal Analysis of the Effect of Liability Pressure on Birth Outcomes

Cited by 22 publications

References 76 publications

Does Litigation Increase or Decrease Health Care Quality?

Does Litigation Increase or Decrease Health Care Quality?

Behavioral Law and Economics: Empirical Methods

The impact of tort reform on defensive medicine, quality of care, and physician supply: A systematic review

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