The impact of malpractice liability claims on obstetrical practice patterns

Abstract

Objectives: This paper examines whether malpractice claims have any impact on obstetrical practice patterns (C-section rates) and physician delivery volume.

Data sources: Secondary data from the 1992-2000 Florida Hospital Inpatient Discharge File, the Florida Medical Professional Liability Insurance Claims File, and the American Medical Association's Master File on physician characteristics.

Study design: The effects of malpractice claims on C-section rates and physician delivery volume were estimated using panel data and a fixed-effects multivariate model.

Data collection: Variables were constructed from each data source and merged into a single panel dataset using consistent physician identifiers. Principal Findings. I did not find evidence that physicians changed their practice patterns by increasing C-section rates in response to malpractice claims. However, physicians performed six fewer inpatient deliveries 3 years after the closing of a malpractice claim, after controlling for individual- and market-level characteristics. Physicians with high malpractice awards of U.S.$250,000 or more performed 14 fewer deliveries on average.

Conclusions: Malpractice claims led to a small reduction in physician delivery volume, but they did not have a significant impact on C-section rates.