First Do No Harm?: Tort Reform and Birth Outcomes

Abstract

We examine the impact of tort reforms using U.S. birth records for 1989-2001. We make four contributions: First, we develop a model that analyzes the incentives created by specific tort reforms. Second, we assemble new data on tort reform. Third, we examine a range of outcomes. Finally, we allow for differential effects by demographic/risk group. We find that reforms of the "deep pockets rule" reduce complications of labor and C-sections, while caps on noneconomic damages increase them. Our results demonstrate there are important interactions between incentives created by tort law and other incentives facing physicians.

Physicians Treating Physicians: Information and Incentives in Childbirth

“…However, in childbirth even the largest empirical estimates are relatively small (Avraham, Dafny, and Schanzenbach 2012). Dubay, Kaestner, and Waidmann (1999) and Sloan et al (1997) find small increases, Kim (2007) finds no effect of malpractice risk on C-sections, and Currie and MacLeod (2008) finds malpractice pressure leads to sizable decreases in C-sections.…”

Do Physicians Respond to Liability Standards?

“…Instead, this literature has viewed the substance of the law in relatively abstract terms and has simply identified the effects of tort law by focusing on variations along the remedy dimension. For instance, in the medical contextwhere our focus will lie in this paper-many studies have attempted to isolate the influence of medical malpractice law by estimating physician responses to the adoption of caps on non-economic damage awards or to similar reforms that largely operate by curbing the expected amount of damages that plaintiffs may recover in the event of liability (Kessler andMcClellan 1996, Currie andMacLeod 2008). Such reforms do not directly alter what is expected of physicians; they simply diminish the harms associated with any deviation from those legal expectations.…”

Can Health Care Information Technology Save Babies?

“…Examples include Miller (2006) on midwives, Bitler and Currie (2005) on nutritional programs for pregnant women and Currie and MacLeod (2008) on tort reform. In the realm of technology, the focus has been on evaluating technologies specific to neonatology, such as neonatal intensive care units (Baker and Phibbs, 2002).…”