New Study Finds Medical Malpractice Caps Lead To Higher Rates Of Preventable Patient Safety Events In Hospitals

162017_132140396847214_292624_nA recently published study found that medical malpractice caps on noneconomic damages, which have been enacted in many states in the United States, have reduced the risk of medical malpractice litigation in those states, which has led to higher rates of preventable adverse patient safety events in hospitals.

The study, entitled, “The Deterrent Effect of Tort Law: Evidence from Medical Malpractice Reform,” looked at results from five states that had enacted caps on noneconomic damages in medical malpractice cases: Texas, which adopted stringent medical malpractice reforms in 2003 ($250,000 for all individuals with a separate $250,000 cap that applies to each hospital or other licensed health care facility, with a maximum of $500,000 for all health care facilities); Florida, which adopted caps on noneconomic damages in medical malpractice cases in 2003 ($500,000 for one or more physicians, plus $750,000 for one or more hospitals, but double the amount for cases involving death, vegetative state, “catastrophic injury,” or “manifest injustice”); Georgia, which adopted its cap in the amount of $350,000 in 2005, but was invalidated in 2010; Illinois, which adopted its cap in 2005 in the amount of $500,000, which was also invalidated in 2010; and, South Carolina, which also adopted its cap in the amount of $350,000 in 2005. (The study’s authors state that their analysis should not be affected by the invalidations of the caps in Georgia and in Illinois because the study ended its sample period in 2010.)

The researchers reported consistent results for the five states: the adoption of damages caps in medical malpractice cases was followed by a broad increase in adverse patient safety events, with an average rise between 10% and 15%, with the exception of death as the outcome, which showed a positive but small and statistically insignificant impact (which the authors of the study suggest may explain why other studies of the impact of medical malpractice tort reforms that use death as the principal outcome conclude that tort reforms have no significant effect on the quality of healthcare in the United States).

The study’s authors found a gradual rise in rates for most PSIs (Patient Safety Indicators, which are standard measures of often preventable adverse events that were developed by the Agency for Healthcare Research and Quality) after medical malpractice reform was adopted, which they found to be consistent with a gradual relaxation of care or the failure to reinforce care standards over time.

The study’s authors concluded, “We find evidence that reduced risk of med mal litigation, due to state adoption of damage caps, leads to higher rates of preventable adverse patient safety events in hospitals. Our study is the first, either for medical malpractice or indeed, in any area of personal injury liability, to find strong evidence consistent with classic tort law deterrence theory – in which liability for harm induces greater care and relaxing liability leads to less care. The drop in care quality occurs gradually over a number of years following adoption of damage caps.”

The authors acknowledge the limitations in their study, including that their data was limited to hospital inpatients and therefore no conclusions could be drawn concerning whether medical malpractice reforms also cause a change in level of care in the outpatient setting. They also acknowledged that they could not link specific adverse events directly to medical malpractice lawsuits.


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This entry was posted on Tuesday, November 4th, 2014 at 6:07 am. Both comments and pings are currently closed.


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