Back to Annual Meeting

Back to Annual Meeting

APHA Scientific Session and Event Listing

Praveen Dhankhar, PhD¹, Mahmud Khan, PhD², and Shalini Bagga¹. (1) Department of Economics, Tulane University, 206 Tilton Hall, Tulane University, New Orleans, LA 70118, 404-277-3067, eop4@cdc.gov, (2) Health Systems Management, Tulane University, 1440 Canal Street, Suite 1900, New Orleans, LA 70112

A number of studies suggest that the risk of medical malpractice lawsuits encourages physicians to practice “defensive medicine” (utilization of medical resources beyond its optimal level of use). This study examines the potential consequences of malpractice pressure on medical care for acute myocardial infarction (AMI) patients. We estimate an AMI patient's probability of receiving any of the three procedures: Percutaneous Transluminal Coronary Angioplasty (PTCA), Coronary Artery Bypass Graft (CABG), or medical management (MM). We also estimate the impact of medical malpractice on mortality of AMI patients. We use Nationwide Inpatient Sample (NIS) data for 2001, and National Practitioner Data Bank (NPDB). Frequency of paid claims is used as a measure of malpractice pressure. We use a multinomial logit model with procedure use as the dependent variable. Results indicate that an increase in medical malpractice risk is associated with a reduction in resource use: use of medical management compared to PTCA, and use of PTCA compared to CABG. Malpractice risk is also associated with improvements in health outcome for patients with less severe medical conditions. Thus, medical malpractice is associated with lower healthcare costs for AMI patients. At least for patients with lower severity, malpractice threat appears to have improved health outcomes despite the increased use of lower-cost interventions. For more severe patients, malpractice threat has no impact on mortality. Therefore, we find no evidence of defensive medicine for AMI patients. The implication of the results is that the medical malpractice pressure may not necessarily be cost-escalating. For the AMI patients, the malpractice threat tends to reduce the costs and improve the health outcomes.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Evaluate the effect of medical malpractice on health care services.
• Define defensive medicine

Keywords: Health Law, Health Care Delivery

Presenting author's disclosure statement:

Not Answered