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Tort Liability and Obstetricians' Care Levels

Author

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  • Sloan, Frank
  • Entman, Stephen S.
  • Reilly, Bridget A.
  • Cheryl A. Glass
  • Gerald B. Hickson
  • Harold H. Zhang

Abstract

In this study, we assess practice changes made in response to the threat of tort liability in the field of obstetrics, which has one of the highest levels of premiums, claim frequency, and mean dollar value of paid claims. There is much "conventional wisdom" about effects of tort liability risk on obstetrical practice based on obstetricians' perceptions of changes that have occurred. Our data comes from the Survey of Obstetrical Care in 1992, a survey of 963 women who had given birth in 1987 in 31 counties in Florida conducted for purposes of this study and related studies of medical malpractice and birth outcomes. Our results suggest that some antenatal testing is responsive to variation in the threat of being used. But for most measures included in our study, half of the antenatal testing variables, the decision to perform a cesarean section, and various dimensions of maternal satisfaction with care, our empirical analysis failed to reveal that obstetricians practice more "defensively" in areas with relatively high suit rates.

Suggested Citation

  • Sloan, Frank & Entman, Stephen S. & Reilly, Bridget A. & Cheryl A. Glass & Gerald B. Hickson & Harold H. Zhang, 1995. "Tort Liability and Obstetricians' Care Levels," Working Papers 95-07, Duke University, Department of Economics.
    • Handle: RePEc:duk:dukeec:95-07
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    References listed on IDEAS

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    1. Peter A. Diamond, 1974. "Single Activity Accidents," The Journal of Legal Studies, University of Chicago Press, vol. 3(1), pages 107-164, January.
    2. Danzon, Patricia M., 1985. "Liability and liability insurance for medical malpractice," Journal of Health Economics, Elsevier, vol. 4(4), pages 309-331, December.
    3. Sloan, Frank A. & Hassan, Mahmud, 1990. "Equity and accuracy in medical malpractice insurance pricing," Journal of Health Economics, Elsevier, vol. 9(3), pages 289-319, November.
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    6. Stafford, R.S., 1990. "Cesarean section use and source of payment: An analysis of California hospital discharge abstracts," American Journal of Public Health, American Public Health Association, vol. 80(3), pages 313-315.
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    Cited by:

    1. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 2001. "Medical malpractice liability and its effect on prenatal care utilization and infant health," Journal of Health Economics, Elsevier, vol. 20(4), pages 591-611, July.
    2. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(2), pages 795-830.
    3. Paola Bertoli & Veronica Grembi, 2018. "Medical Malpractice: How Legal Liability Affects Medical Decisions," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 235-261, Emerald Group Publishing Limited.
    4. Sofia Amaral‐Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence from Italy," Health Economics, John Wiley & Sons, Ltd., vol. 24(9), pages 1050-1064, September.
    5. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    6. 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.
    7. Brian K. Chen & Chun‐Yuh Yang, 2014. "Increased Perception of Malpractice Liability and the Practice of Defensive Medicine," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 11(3), pages 446-476, September.
    8. Malak, Natalie & Yang, Y. Tony, 2019. "A re-examination of the effects of tort reforms on obstetrical procedures and health outcomes," Economics Letters, Elsevier, vol. 184(C).
    9. Sloan, Frank A. & Shadle, John H., 2009. "Is there empirical evidence for "Defensive Medicine"? A reassessment," Journal of Health Economics, Elsevier, vol. 28(2), pages 481-491, March.
    10. Paul Fenn & Alastair Gray & Neil Rickman, 2004. "Liability, insurance and defensive medicine: new evidence," School of Economics Discussion Papers 0304, School of Economics, University of Surrey.
    11. Chetty, V. K., 1998. "Stochastic technology, production organization and costs," Journal of Health Economics, Elsevier, vol. 17(2), pages 187-210, April.
    12. Fenn, Paul & Gray, Alastair & Rickman, Neil, 2007. "Liability, insurance and medical practice," Journal of Health Economics, Elsevier, vol. 26(5), pages 1057-1070, September.

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