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Do Doctors Prescribe Antibiotics Out of Fear of Malpractice?

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  • Panthöfer, S.

Abstract

This paper investigates whether doctors prescribe antibiotics to protect themselves against potential malpractice claims. Using data from the National Ambulatory Medical Care Survey on more than half a million outpatient visits between 1993 and 2011, I find that doctors are 6% less likely to prescribe antibiotics after the introduction of a cap on noneconomic damages. Over 140 million discharge records from the Nationwide Inpatient Sample do not reveal a corresponding change in hospital stays for conditions that can potentially be avoided through antibiotic use in the outpatient setting. These findings, as well as a stylized model of antibiotic prescribing under the threat of malpractice, suggest that liability-reducing tort reforms can decrease the amount of antibiotics that are inappropriately prescribed for defensive reasons.

Suggested Citation

  • Panthöfer, S., 2016. "Do Doctors Prescribe Antibiotics Out of Fear of Malpractice?," Health, Econometrics and Data Group (HEDG) Working Papers 16/31, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:16/31
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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. Shurtz, Ity, 2013. "The impact of medical errors on physician behavior: Evidence from malpractice litigation," Journal of Health Economics, Elsevier, vol. 32(2), pages 331-340.
    3. 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.
    4. Ronen Avraham, 2007. "An Empirical Study of the Impact of Tort Reforms on Medical Malpractice Settlement Payments," The Journal of Legal Studies, University of Chicago Press, vol. 36(S2), pages 183-229, June.
    5. Alberto Abadie & Susan Athey & Guido W Imbens & Jeffrey M Wooldridge, 2023. "When Should You Adjust Standard Errors for Clustering?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 138(1), pages 1-35.
    6. 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.
    7. Ity Shurtz, 2014. "Malpractice Law, Physicians' Financial Incentives, and Medical Treatment: How Do They Interact?," Journal of Law and Economics, University of Chicago Press, vol. 57(1), pages 1-29.
    8. Kwon, Illoong & Jun, Daesung, 2015. "Information disclosure and peer effects in the use of antibiotics," Journal of Health Economics, Elsevier, vol. 42(C), pages 1-16.
    9. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CERGE-EI Working Papers wp540, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    10. Andrew Friedson & Thomas Kniesner, 2012. "Losers and losers: Some demographics of medical malpractice tort reforms," Journal of Risk and Uncertainty, Springer, vol. 45(2), pages 115-133, October.
    11. Toshiaki Iizuka, 2007. "Experts' agency problems: evidence from the prescription drug market in Japan," RAND Journal of Economics, RAND Corporation, vol. 38(3), pages 844-862, September.
    12. Heckman, J.J. & Hotz, V.J., 1988. "Choosing Among Alternative Nonexperimental Methods For Estimating The Impact Of Social Programs: The Case Of Manpower Training," University of Chicago - Economics Research Center 88-12, Chicago - Economics Research Center.
    13. 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.
    14. 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.
    15. Daniel Bennett & Che-Lun Hung & Tsai-Ling Lauderdale, 2015. "Health Care Competition and Antibiotic Use in Taiwan," Journal of Industrial Economics, Wiley Blackwell, vol. 63(2), pages 371-393, June.
    16. Avraham, Ronen & Schanzenbach, Max, 2015. "The impact of tort reform on intensity of treatment: Evidence from heart patients," Journal of Health Economics, Elsevier, vol. 39(C), pages 273-288.
    17. Daniel P. Kessler, 2011. "Evaluating the Medical Malpractice System and Options for Reform," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 93-110, Spring.
    18. Marianne Bertrand & Esther Duflo & Sendhil Mullainathan, 2004. "How Much Should We Trust Differences-In-Differences Estimates?," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 119(1), pages 249-275.
    19. Anca M. Cotet, 2012. "The Impact of Noneconomic Damages Cap on Health Care Delivery in Hospitals," American Law and Economics Review, American Law and Economics Association, vol. 14(1), pages 192-234.
    20. 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.
    21. Michael Frakes & Jonathan Gruber, 2019. "Defensive Medicine: Evidence from Military Immunity," American Economic Journal: Economic Policy, American Economic Association, vol. 11(3), pages 197-231, August.
    22. Myungho Paik & Bernard Black & David A. Hyman, 2016. "Damage Caps and the Labor Supply of Physicians: Evidence from the Third Reform Wave," American Law and Economics Review, American Law and Economics Association, vol. 18(2), pages 463-505.
    23. Currie, Janet & Lin, Wanchuan & Meng, Juanjuan, 2014. "Addressing antibiotic abuse in China: An experimental audit study," Journal of Development Economics, Elsevier, vol. 110(C), pages 39-51.
    24. repec:oup:alecon:v:18:y:2016:i:2:p:463-505. is not listed on IDEAS
    25. Eric Helland & Darius Lakdawalla & Anup Malani & Seth A Seabury, 2020. "Unintended Consequences of Products Liability: Evidence from the Pharmaceutical Market [“An Economic Analysis of Mary Carter Settlement Agreements,”]," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 36(3), pages 598-632.
    26. Kathryn Zeiler & Charles Silver & Bernard Black & David A. Hyman & William M. Sage, 2007. "Physicians' Insurance Limits and Malpractice Payments: Evidence from Texas Closed Claims, 1990-2003," The Journal of Legal Studies, University of Chicago Press, vol. 36(S2), pages 9-45, June.
    27. 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.
    28. Yiling Deng & George Zanjani, 2018. "What Drives Tort Reform Legislation? An Analysis Of State Decisions To Restrict Liability Torts," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 85(4), pages 959-991, December.
    29. 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.
    30. 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.
    31. Fogelberg, Sara, 2013. "Effects of Competition between Healthcare Providers on Prescription of Antibiotics," Working Paper Series 949, Research Institute of Industrial Economics, revised 20 Nov 2014.
    32. Myungho Paik & Bernard Black & David Hyman, 2013. "The Receding Tide of Medical Malpractice Litigation: Part 2—Effect of Damage Caps," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 10(4), pages 639-669, December.
    33. 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.
    34. Lundin, Douglas, 2000. "Moral hazard in physician prescription behavior," Journal of Health Economics, Elsevier, vol. 19(5), pages 639-662, September.
    35. Michael Frakes, 2012. "Defensive Medicine and Obstetric Practices," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 9(3), pages 457-481, September.
    36. David Dranove & Subramaniam Ramanarayanan & Yasutora Watanabe, 2012. "Delivering Bad News: Market Responses to Negligence," Journal of Law and Economics, University of Chicago Press, vol. 55(1), pages 1-25.
    37. A. J. Culyer & J. P. Newhouse (ed.), 2000. "Handbook of Health Economics," Handbook of Health Economics, Elsevier, edition 1, volume 1, number 1.
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    1. Bertrand Crettez & Régis Deloche & Marie‐Hélène Jeanneret‐Crettez, 2020. "A demand‐induced overtreatment model with heterogeneous experts," Journal of Public Economic Theory, Association for Public Economic Theory, vol. 22(5), pages 1713-1733, September.

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    More about this item

    Keywords

    antibiotic misuse; antibiotic resistance; liability pressure; defensive medicine;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • 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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