Does Medical Malpractice Law Improve Health Care Quality?

Frakes, Michael D.; Jena, Anupam B.

doi:10.3386/w19841

Cited by 20 publications

(44 citation statements)

References 14 publications

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“…Carvell et al (2012) provide evidence that joint and several liability tort reforms have been accompanied by reductions in the non-auto, non-overdose accidental death rate. However, Frakes and Jena (2014) find only small and statistically insignificant effects of changes in malpractice pressure (in terms of non-economic damages caps) on different measures of health care treatment quality. Similarly, Sloan and Shadle (2009) conclude, based on the analysis of eight different reform types, that neither medical decisions nor patient outcomes are systematically affected by tort reforms.…”

Section: Related Work and Literature Reviewmentioning

confidence: 73%

The role of party politics in medical malpractice tort reforms

Matter

Stutzer

2016

European Journal of Political Economy

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The U.S. tort system has experienced various reforms over the last three decades. While there is an extensive literature on the consequences of these reforms, very little is known about their determinants. In this study, we investigate the role of party politics in the reform process across U.S. states. In order to test whether any party effect goes beyond voter preferences, we apply the idea behind regression discontinuity studies based on close electoral outcomes to semi-parametric proportional hazards models. We find that in states with close election outcomes, a narrow Republican majority in the lower house is associated with a 50 to 150 percent higher risk of tort reform enactment compared to a narrow Democratic majority. Our results indicate that party politics plays a role in tort reforms goes over and above potential underlying preferences in the constituency. (JEL classification: D72, K13)

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Section: Related Work and Literature Reviewmentioning

confidence: 73%

The role of party politics in medical malpractice tort reforms

Matter

Stutzer

2016

European Journal of Political Economy

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“…Eight studies evaluated the impact of caps on noneconomic damages on quality of care. 20,21,26,28,29,33,34,41 Avraham and Schanzenbach 20 found that noneconomic damages were associated with a significant decrease in mortality for those aged 45-65 years (about 1.4 percent), but no significant difference for those aged 65-90 years. Currie and Macleod observed that caps on noneconomic damages were associated with a significant increase in preventable complications of labor (6.0 percent).…”

Section: Quality Of Carementioning

confidence: 99%

“…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%

“…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 12,16,20,31,35,43,44,48 of which five (63 percent) used a difference-in-differences specification. 12,16,35,43,44 Thirteen studies evaluated the association of tort reform with physician supply 24,27,30,32,34,36,39,40,42,45,46,50,53 of which nine (69 percent) used a difference-in-differences specification.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…12,16,35,43,44 Thirteen studies evaluated the association of tort reform with physician supply 24,27,30,32,34,36,39,40,42,45,46,50,53 of which nine (69 percent) used a difference-in-differences specification. 12,16,[27][28][29][30]32,[34][35][36]38,40,[42][43][44][45][46] The study characteristics are summarized in Table 3 and presented in detail in Table S1.…”

Section: Study Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

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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The effect of malpractice law on physician supply: Evidence from negligence-standard reforms

Frakes

Frank

Seabury

2020

Journal of Health Economics

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We explore whether the composition of the physician work force is impacted by the clinical standards imposed on physicians under medical liability rules. We theorize that physicians of particular backgrounds will be attracted to regions when the malpractice laws of those regions favor the type of medicine characteristic of those backgrounds. To test this prediction, we rely on a quasi-experiment made possible by states shifting from local to national customs as the basis for setting standards at court, a distinction that captures meaningful differences in the clinical expectations of the law in light of the well documented phenomenon of regional variations in medical practices. Using data from the Area Health Resource File from 1977 to 2005, we find that the rate of surgeons among practicing physicians increases by 2-2.4 log points following the adoption of national-standard laws in initially low surgery-rate regions-i.e., following a change in the law that effectively expects physicians to increase practice intensities. We find that this response is nearly three times greater in rural counties. We also find that this supply effect is unidirectional, with no evidence to suggest that surgeons retreat when initially high-surgery-rate regions change their laws so as to expect less intensive practice styles.

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Does Medical Malpractice Law Improve Health Care Quality?

Cited by 20 publications

References 14 publications

The role of party politics in medical malpractice tort reforms

The role of party politics in medical malpractice tort reforms

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

The effect of malpractice law on physician supply: Evidence from negligence-standard reforms

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