What is the profile of patients thinking of litigation? Results from the hospitalized and outpatients' profile and expectations study

Hippokratia. 2014 Apr;18(2):139-43.


Background: Patients vary considerably in their intentions to pursue legal action following a medical error. The aim of this study was to explore predictors of litigious intentions in both hospitalized patients and outpatients, determining the relative influences of patients' characteristics, help-seeking behavior, information-seeking attitudes and general health status factors.

Methods: A representative cross-section of the urologic clinic of a general academic hospital and the associated outpatient clinic was used (a total of 226 patients, 145 outpatients). Data were gathered using in-person interviews conducted by trained psychologists. Attitudes were assessed by "General statements about medical errors", while expectations for information by "Krantz's Health Opinion Survey" (KHOS).

Results: A single multivariate model explained 21.5% of the variance of litigious intentions. Younger age (explained 7.6% of the variation, p=0.04), weaker relationship with religion (4%, p=0.02), less than 15 visits/year to any physician (7.2%, p=0.001), outpatient status (2.4%, p=0.02), and higher expectations for information were associated with higher possibility to consider suing their physician (7.6%, p=0.002). Patients' desire for disclosure of a medical error (agreement in 82.2%) exceeded their expectations for financial compensation, particularly in less severe cases (agreement in 24.1%).

Conclusions: This is the first report on the profile of patients with high potential for malpractice suits as predicted by patients' age, relationship with religion, health-seeking and information-seeking behavior. Respecting patients' need for information during clinical consultations and proceeding to disclosure of medical errors, when they occur, seems to be not only the more patient-centered approach, but also the best way to lessen the likelihood of a claim. Hippokratia 2014; 18 (2):139-143.

Keywords: Malpractice; disclosure; litigious intentions; medical error; patient-centered.