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Medical practice and malpractice litigation in an evolutionary context

Author

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  • Angelo Antoci

    (University of Sassari)

  • Alessandro Fiori Maccioni

    (University of Sassari)

  • Paolo Russu

    (University of Sassari)

Abstract

We model the interactions between the behaviors of physicians and patients, subject to clinical and legal risks, by means of evolutionary game theory. We propose an original game in which patients may sue their physician for medical malpractice, and physicians have to choose between two alternative treatments, with different levels of benefits and risks. The safer treatment is also the less effective, therefore its provision corresponds, under the assumptions of our model, to practicing negative defensive medicine. We study the Nash equilibria, test their stability in the replicator dynamics, and analyze their welfare properties. We find that the accuracy of the judicial system plays an important role, with possible counter-intuitive effects related to legal reforms. If the court is not sufficiently accurate, defensive medicine can be favored, paradoxically, by an increase in the probability that defensive physicians are sanctioned by the court. A similar outcome can be generated also by an increase in the compensation paid to patients by physicians, when sanctioned for medical malpractice.

Suggested Citation

  • Angelo Antoci & Alessandro Fiori Maccioni & Paolo Russu, 2018. "Medical practice and malpractice litigation in an evolutionary context," Journal of Evolutionary Economics, Springer, vol. 28(4), pages 915-928, September.
    • Handle: RePEc:spr:joevec:v:28:y:2018:i:4:d:10.1007_s00191-018-0578-0
    DOI: 10.1007/s00191-018-0578-0
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    References listed on IDEAS

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    Cited by:

    1. Dylan Martin-Lapoirie, 2022. "Teamwork in health care and medical malpractice liability: an experimental investigation," European Journal of Law and Economics, Springer, vol. 54(2), pages 251-282, October.
    2. Antoci, Angelo & Fiori Maccioni, Alessandro & Russu, Paolo & Sacco, Pier Luigi, 2022. "Curing is caring? Liability reforms, defensive medicine and malpractice litigation in a post-pandemic world," Socio-Economic Planning Sciences, Elsevier, vol. 80(C).
    3. Danilo Delpini & Paolo Russu, 2022. "The Effects of Defensive Medicine in Physician–Patient Dynamics: An Agent-Based Approach," Dynamic Games and Applications, Springer, vol. 12(4), pages 1067-1085, December.

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    More about this item

    Keywords

    Defensive medicine; Malpractice litigation; Clinical risk; Legal risk; Evolutionary game;
    All these keywords.

    JEL classification:

    • C73 - Mathematical and Quantitative Methods - - Game Theory and Bargaining Theory - - - Stochastic and Dynamic Games; Evolutionary Games
    • I10 - Health, Education, and Welfare - - Health - - - General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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