Economic Analysis of Medical Malpractice Liability and Its Reform

Arlen, Jennifer

doi:10.2139/ssrn.2262792

Cited by 18 publications

(12 citation statements)

References 96 publications

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“…In theory, legal liability incentivizes providers to internalize the costs of their mistakes and take appropriate care to avoid them, which can promote the provision of safe and effective care (Arlen, 2013). For example, if a provider knows that she faces a 10% chance of causing a $10,000 harm to a patient and being held liable for that harm, then she has a financial incentive to invest $500 in learning a new technique that reduces the probability of harm (and liability) to only 5%.…”

Section: Malpractice Liabilitymentioning

confidence: 99%

The Extraregulatory Effect of Nurse Practitioner Scope-of-Practice Laws on Physician Malpractice Rates

2017

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Patients can hold physicians directly or vicariously liable for the malpractice of nurse practitioners under their supervision. Restrictive scope-of-practice laws governing nurse practitioners can ease patients' legal burdens in establishing physician liability. We analyze the effect of restrictive scope-of-practice laws on the number of malpractice payments made on behalf of physicians between 1999 and 2012. Enacting less restrictive scope-of-practice laws decreases the number of payments made by physicians by as much as 31%, suggesting that restrictive scope-of-practice laws have a salient extraregulatory effect on physician malpractice rates. The effect of enacting less restrictive laws varies depending on the medical malpractice reforms that are in place, with the largest decrease in physician malpractice rates occurring in states that have enacted fewer malpractice reforms. Relaxing scope-of-practice laws could mitigate the adverse extraregulatory effect on physicians identified in this study and could also lead to improvements in access to care.

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Section: Malpractice Liabilitymentioning

confidence: 99%

The Extraregulatory Effect of Nurse Practitioner Scope-of-Practice Laws on Physician Malpractice Rates

2017

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“…Several rationales have been used to oppose the introduction of experience‐rated premiums at the individual physician level (e.g., a high variability of claims over short time periods, which makes it difficult to obtain a stable risk estimate). However, those arguments do not necessarily hold at the hospital level, and there is an ongoing debate over whether experience‐rated premiums at the hospital level should be extensively adopted (Arlen, ; Mello, ; Sloan, ; Ellis et. al , ).…”

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confidence: 99%

Does Experience Rating Improve Obstetric Practices? Evidence from Italy

2015

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Using inpatient discharge records from the Italian region of Piedmont, we estimate the impact of an increase in malpractice pressure brought about by experience-rated liability insurance on obstetric practices. Our identification strategy exploits the exogenous location of public hospitals in court districts with and without schedules for noneconomic damages. We perform difference-in-differences analysis on the entire sample and on a subsample which only considers the nearest hospitals in the neighborhood of court district boundaries. We find that the increase in medical malpractice pressure is associated with a decrease in the probability of performing a C-section from 2.3 to 3.7 percentage points (7-11.6%) with no consequences for medical complications or neonatal outcomes. The impact can be explained by a reduction in the discretion of obstetric decision-making rather than by patient cream skimming.

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“…59 Smatra se kako od 4 do18 % pacijenata trpe posljedice liječničke nepažnje u obavljanju medicinskog tretmana sa brojnim štetnim posljedicama na zdravlje i ekonomsku sferu pacijenata, pritom tek manji broj štetnih događaja biva predmetom građanskopravnog postupka za naknadu štete. 60 Neovisno o tome, financijski izdatci uvjetovani postupanjem liječnika contra legem artis izravno dovode do povećanja bolničkih rashoda u rasponu od 1.246,00 do 4.769,00 USD godišnje, ovisno o tipu zdravstvene ustanove i specifičnom medicinskom tretmanu koje se tamo provodi. Prema američkom Institute of Medicine ukupni godišnji izdatci po različitim osnovama, a koji su per directum et indirectum izazvani postupanjem liječnika i drugog zdravstvenog osoblja protivnom pravilima medicinske struke procjenjuju se na čak od 17 do 29 milijardi dolara godišnje!…”

Section: Financijski Učinci I Trendovi Odštetnopravne Odgovornosti Zbunclassified

Građanskopravna odgovornost za povredu medicinskog standarda i prateći ekonomski učinci

Vojković¹

2019

Zb. Prav. fak. Sveuč. Rij. (Online)

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U radu je analiziran građanskopravni aspekt povrede medicinskog standarda tijekom pružanja usluge medicinskog postupanja te se ukazalo na različite pojavne oblike liječničke pogreške. Uobičajeni je modus povrede medicinskog standarda liječnička pogreška, koja se neovisno o tipološkim značajkama očituje, in genere, u postupanju liječnika, protivno pravilima zdravstvene struke te njenim moralnim i etičkim načelima, odnosno kao postupanje u neskladu s provjerenim standardima suvremene medicinske znanosti. U okviru provedenog istraživanja utvrđen je conceptum pravno relevantnoga medicinskog standarda na temelju imaginarnog modela ponašanja liječnika u okviru medicinskoga tretmana in concreto. Pritom se kao relevantan pravni standard uzima pažnja dobroga gospodarstvenika i dobroga stručnjaka, a njegovo pridržavanje smanjuje rizik od suboptimalnog tretmana koji bi bio suprotan pravilima medicinske profesije - contra legis artis. Primjena pravila dužne pažnje, odnosno, odštetnopravni sustav sa svojim pravnim i ekonomskim implikacijama, in ultima linea, dovodi do toga da mogući štetnik (liječnik/zdravstvena ustanova) medicinsku uslugu nastoji obavljati u režimu standarda optimalne skrbi, budući da pravni sustav navedeni standard medicinskog postupanja izjednačuje s ekonomskom kategorijom optimalne skrbi za pacijenta.

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Economic Analysis of Medical Malpractice Liability and Its Reform

Cited by 18 publications

References 96 publications

The Extraregulatory Effect of Nurse Practitioner Scope-of-Practice Laws on Physician Malpractice Rates

The Extraregulatory Effect of Nurse Practitioner Scope-of-Practice Laws on Physician Malpractice Rates

Does Experience Rating Improve Obstetric Practices? Evidence from Italy

Građanskopravna odgovornost za povredu medicinskog standarda i prateći ekonomski učinci

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