Gilbert W Gimm1. 1. Mathematica Policy Research, 600 Maryland Avenue, S.W., Suite 550, Washington, DC 20024, USA. ggimm@mathematica-mpr.com
Abstract
OBJECTIVES: This paper examines whether malpractice claims have any impact on obstetrical practice patterns (C-section rates) and physician delivery volume. DATA SOURCES: Secondary data from the 1992-2000 Florida Hospital Inpatient Discharge File, the Florida Medical Professional Liability Insurance Claims File, and the American Medical Association's Master File on physician characteristics. STUDY DESIGN: The effects of malpractice claims on C-section rates and physician delivery volume were estimated using panel data and a fixed-effects multivariate model. DATA COLLECTION: Variables were constructed from each data source and merged into a single panel dataset using consistent physician identifiers. Principal Findings. I did not find evidence that physicians changed their practice patterns by increasing C-section rates in response to malpractice claims. However, physicians performed six fewer inpatient deliveries 3 years after the closing of a malpractice claim, after controlling for individual- and market-level characteristics. Physicians with high malpractice awards of U.S.$250,000 or more performed 14 fewer deliveries on average. CONCLUSIONS: Malpractice claims led to a small reduction in physician delivery volume, but they did not have a significant impact on C-section rates.
OBJECTIVES: This paper examines whether malpractice claims have any impact on obstetrical practice patterns (C-section rates) and physician delivery volume. DATA SOURCES: Secondary data from the 1992-2000 Florida Hospital Inpatient Discharge File, the Florida Medical Professional Liability Insurance Claims File, and the American Medical Association's Master File on physician characteristics. STUDY DESIGN: The effects of malpractice claims on C-section rates and physician delivery volume were estimated using panel data and a fixed-effects multivariate model. DATA COLLECTION: Variables were constructed from each data source and merged into a single panel dataset using consistent physician identifiers. Principal Findings. I did not find evidence that physicians changed their practice patterns by increasing C-section rates in response to malpractice claims. However, physicians performed six fewer inpatient deliveries 3 years after the closing of a malpractice claim, after controlling for individual- and market-level characteristics. Physicians with high malpractice awards of U.S.$250,000 or more performed 14 fewer deliveries on average. CONCLUSIONS: Malpractice claims led to a small reduction in physician delivery volume, but they did not have a significant impact on C-section rates.
Authors: Michelle M Mello; David M Studdert; Jennifer Schumi; Troyen A Brennan; William M Sage Journal: Health Aff (Millwood) Date: 2007-04-24 Impact factor: 6.301
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