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Does Medical Malpractice Law Improve Health Care Quality?


  • Michael Frakes
  • Anupam B. Jena


Despite the fundamental role of deterrence in justifying a system of medical malpractice law, surprisingly little evidence has been put forth to date bearing on the relationship between medical liability forces on the one hand and medical errors and health care quality on the other. In this paper, we estimate this relationship using clinically validated measures of health care treatment quality constructed with data from the 1979 to 2005 National Hospital Discharge Surveys and the 1987 to 2008 Behavioral Risk Factor Surveillance System records. Drawing upon traditional, remedy-centric tort reforms--e.g., damage caps--we estimate that the current liability system plays at most a modest role in inducing higher levels of health care quality. We contend that this limited independent role for medical liability may be a reflection upon the structural nature of the present system of liability rules, which largely hold physicians to standards determined according to industry customs. We find evidence suggesting, however, that physician practices may respond more significantly upon a substantive alteration of this system altogether--i.e., upon a change in the clinical standards to which physicians are held in the first instance. The literature to date has largely failed to appreciate the substantive nature of liability rules and may thus be drawing limited inferences based solely on our experiences to date with damage-caps and related reforms.

Suggested Citation

  • Michael Frakes & Anupam B. Jena, 2014. "Does Medical Malpractice Law Improve Health Care Quality?," NBER Working Papers 19841, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:19841
    Note: HC HE LE

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    Cited by:

    1. Matter, Ulrich & Stutzer, Alois, 2015. "Politico-economic determinants of tort reforms in medical malpractice," Working papers 2015/02, Faculty of Business and Economics - University of Basel.
    2. Patricia H. Born & J. Bradley Karl, 2016. "The Effect of Tort Reform on Medical Malpractice Insurance Market Trends," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 13(4), pages 718-755, December.
    3. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    4. Matter, Ulrich & Stutzer, Alois, 2016. "The role of party politics in medical malpractice tort reforms," European Journal of Political Economy, Elsevier, vol. 42(C), pages 17-35.
    5. Galasso, Alberto & Luo, Hong, 2018. "How does product liability risk affect innovation? Evidence from medical implants," CEPR Discussion Papers 13036, C.E.P.R. Discussion Papers.
    6. Alberto Galasso & Hong Luo, 2018. "When does Product Liability Risk Chill Innovation? Evidence from Medical Implants," NBER Working Papers 25068, National Bureau of Economic Research, Inc.
    7. Panthöfer, Sebastian, 2016. "Tort Reform and the Length of Physician Office Visits," UC3M Working papers. Economics 23861, Universidad Carlos III de Madrid. Departamento de Economía.
    8. Michael D. Frakes & Jonathan Gruber, 2018. "Defensive Medicine: Evidence from Military Immunity," NBER Working Papers 24846, National Bureau of Economic Research, Inc.

    More about this item

    JEL classification:

    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • K13 - Law and Economics - - Basic Areas of Law - - - Tort Law and Product Liability; Forensic Economics

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