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Medical errors: Getting the incentives right

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Author Info
Grepperud, Sverre () (Institute of Health Management and Health Economics)
Abstract

This work examines the role of penalties as providers of incentives to prevent medical errors and ensure that such incidents, once they occur, become common knowledge. It is shown that a scheme with two penalties (accountability and non-report) is able to induce the first-best solution. However, this scheme needs not imply a punitive environment, but may, under given circumstances, yield insignificant and even negative penalties. Alternative incentive systems, such as voluntary reporting and legal immunity, are found to have less desirable properties. An exception is the principle of confidentiality (anonymity) which turns out to be an optimal scheme. It is also shown that when a judicial upper limit is binding, for the non-report penalty, it becomes rationale to go “soft” on the accountability penalty.

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File URL: http://www.hero.uio.no/publicat/2003/HERO2003_10.pdf
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Publisher Info
Paper provided by Oslo University, Health Economics Research Programme in its series HERO On line Working Paper Series with number 2003:10.

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Length: 27 pages
Date of creation: 21 Jun 2009
Date of revision:
Handle: RePEc:hhs:oslohe:2003_010

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Postal: HERO / Institute of Health Management and Health Economics P.O. Box 1089 Blindern, N-0317 Oslo, Norway
Phone: 2307 5309
Fax: 2307 5310
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Web page: http://www.hero.uio.no/eng.html
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Related research
Keywords: Iatrogenic injury; adverse events; reporting incentives; confidentiality;

Find related papers by JEL classification:
D82 - Microeconomics - - Information, Knowledge, and Uncertainty - - - Asymmetric and Private Information
I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
K42 - Law and Economics - - Legal Procedure, the Legal System, and Illegal Behavior - - - Illegal Behavior and the Enforcement of Law

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References listed on IDEAS
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  1. Daniel P. Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," NBER Working Papers 5466, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  2. Danzon, Patricia M., 2000. "Liability for medical malpractice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 26, pages 1339-1404 Elsevier. [Downloadable!] (restricted)
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  3. Thornton, James, 1999. "The Impact of Medical Malpractice Insurance Cost on Physician Behaviour: The Role of Income and Tort Signal Effects," Applied Economics, Taylor and Francis Journals, vol. 31(7), pages 779-94, July. [Downloadable!] (restricted)
  4. Lewin, Jeff L. & Trumbull, William N., 1990. "The social value of crime?," International Review of Law and Economics, Elsevier, vol. 10(3), pages 271-284, December. [Downloadable!] (restricted)
  5. Gary S. Becker, 1968. "Crime and Punishment: An Economic Approach," Journal of Political Economy, University of Chicago Press, vol. 76, pages 169. [Downloadable!] (restricted)
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  6. Kessler, Daniel & McClellan, Mark, 1996. "Do Doctors Practice Defensive Medicine?," The Quarterly Journal of Economics, MIT Press, vol. 111(2), pages 353-90, May. [Downloadable!] (restricted)
  7. James Andreoni & Brian Erard & Jonathan Feinstein, 1998. "Tax Compliance," Journal of Economic Literature, American Economic Association, vol. 36(2), pages 818-860, June. [Downloadable!] (restricted)
  8. Harrington, Winston, 1988. "Enforcement leverage when penalties are restricted," Journal of Public Economics, Elsevier, vol. 37(1), pages 29-53, October. [Downloadable!] (restricted)
  9. Heyes, Anthony G., 1996. "Cutting environmental penalties to protect the environment," Journal of Public Economics, Elsevier, vol. 60(2), pages 251-265, May. [Downloadable!] (restricted)
  10. Kessler, Daniel & McClellan, Mark, 2002. "Malpractice law and health care reform: optimal liability policy in an era of managed care," Journal of Public Economics, Elsevier, vol. 84(2), pages 175-197, May. [Downloadable!] (restricted)
  11. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August. [Downloadable!] (restricted)
  12. Jensen, Gail A. & Spurr, Stephen J. & Weycker, Derek A. & Bulycheva, Maria, 1999. "Physicians and the risk of medical malpractice: The role of prior litigation in predicting the future," The Quarterly Review of Economics and Finance, Elsevier, vol. 39(2), pages 267-289. [Downloadable!] (restricted)
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