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The Effects of Defensive Medicine in Physician–Patient Dynamics: An Agent-Based Approach

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  • Danilo Delpini

    (University of Sassari)

  • Paolo Russu

    (University of Sassari)

Abstract

We analyze different scenarios of defensive medicine in a novel framework based on game theory and network analysis, where links in the network represent healing relationships between a physician and a patient. The physician should choose between providing the optimal treatment or an inferior one, which can amount to practicing defensive medicine. The patient should choose whether to litigate or not if an adverse event occurs. A major result of such analysis is that the steady state does not depend on the litigiousness of the initial system or the initial distribution of strategies among physicians or the distribution of patients over physicians. Moreover, reaching a virtuous steady state or an entirely defensive one appears to be independent of the fact that patients take into account the quality of treatments directly or they rely merely on popularity when choosing their physicians.

Suggested Citation

  • 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.
  • Handle: RePEc:spr:dyngam:v:12:y:2022:i:4:d:10.1007_s13235-022-00447-x
    DOI: 10.1007/s13235-022-00447-x
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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.
    2. Eberhard Feess, 2012. "Malpractice liability, technology choice and negative defensive medicine," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 13(2), pages 157-167, April.
    3. Marie Allard & Pierre Thomas Léger & Lise Rochaix, 2009. "Provider Competition in a Dynamic Setting," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 18(2), pages 457-486, June.
    4. Gal-Or, Esther, 1999. "Optimal Reimbursement and Malpractice Sharing Rules in Health Care Markets," Journal of Regulatory Economics, Springer, vol. 16(3), pages 237-265, November.
    5. He, Alex Jingwei, 2014. "The doctor–patient relationship, defensive medicine and overprescription in Chinese public hospitals: Evidence from a cross-sectional survey in Shenzhen city," Social Science & Medicine, Elsevier, vol. 123(C), pages 64-71.
    6. Olbrich, Anja, 2008. "Heterogeneous physicians, lawsuit costs, and the negligence rule," International Review of Law and Economics, Elsevier, vol. 28(1), pages 78-88, March.
    7. Angelo Antoci & Alessandro Fiori Maccioni & Paolo Russu, 2016. "The Ecology of Defensive Medicine and Malpractice Litigation," PLOS ONE, Public Library of Science, vol. 11(3), pages 1-15, March.
    8. Lien, Hsien-Ming & Albert Ma, Ching-To & McGuire, Thomas G., 2004. "Provider-client interactions and quantity of health care use," Journal of Health Economics, Elsevier, vol. 23(6), pages 1261-1283, November.
    9. Daniel Kessler & Mark McClellan, 1996. "Do Doctors Practice Defensive Medicine?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 111(2), pages 353-390.
    10. Danilo Delpini & Stefano Battiston & Guido Caldarelli & Massimo Riccaboni, 2019. "Systemic risk from investment similarities," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-15, May.
    11. 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.
    12. Ma, Ching-to Albert & McGuire, Thomas G, 1997. "Optimal Health Insurance and Provider Payment," American Economic Review, American Economic Association, vol. 87(4), pages 685-704, September.
    13. Elad Asher & Sari Greenberg-Dotan & Jonathan Halevy & Shimon Glick & Haim Reuveni, 2012. "Defensive Medicine in Israel – A Nationwide Survey," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-7, August.
    14. Caldarelli, Guido, 2007. "Scale-Free Networks: Complex Webs in Nature and Technology," OUP Catalogue, Oxford University Press, number 9780199211517.
    15. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    16. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
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