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Malpractice risk and medical treatment selection

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  • Bertoli, Paola
  • Grembi, Veronica

Abstract

We study how legal and financial incentives affect medical decisions. Using patient-level data from Italy, we identify the effect of a change in medical liability pressure by exploiting the geographical distribution of hospitals across court districts, where some districts increase the predictability of expected damages per injury while others do not. Using a difference-in-differences identification strategy, we show that as certainty of compensation increases, c-sections increase by 6.5 percentage points. There is no statistically significant effect on secondary health outcomes of either mothers or newborns, but the increase is higher for low-risk than high-risk mothers. The increase is driven by hospitals that have lower quality, are governed by inefficient court districts, face lower expected damages, and are paid more per c-section.

Suggested Citation

  • Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    • Handle: RePEc:eee:pubeco:v:174:y:2019:i:c:p:22-35
    DOI: 10.1016/j.jpubeco.2019.03.010
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    Cited by:

    1. Gabriel Facchini, 2022. "Forgetting‐by‐not‐doing: The case of surgeons and cesarean sections," Health Economics, John Wiley & Sons, Ltd., vol. 31(3), pages 481-495, March.
    2. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Neighborhoods, networks, and delivery methods," Journal of Health Economics, Elsevier, vol. 80(C).
    3. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    4. Howard, David H. & McCarthy, Ian, 2021. "Deterrence effects of antifraud and abuse enforcement in health care," Journal of Health Economics, Elsevier, vol. 75(C).
    5. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    6. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    7. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    8. Jingshu Luo & Hua Chen & Martin Grace, 2022. "Medicaid expansion, tort reforms, and medical liability costs," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 89(3), pages 789-821, September.

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    More about this item

    Keywords

    Scheduled damages; Cesarean sections; Difference in differences;
    All these keywords.

    JEL classification:

    • K13 - Law and Economics - - Basic Areas of Law - - - Tort Law and Product Liability; Forensic Economics
    • K32 - Law and Economics - - Other Substantive Areas of Law - - - Energy, Environmental, Health, and Safety Law
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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