Defensive Medicine and Obstetric Practices

Michael Frakes

Journal of Empirical Legal Studies, 2012, vol. 9, issue 3, 457-481

Abstract: Using data on physician behavior from the 1979–2005 National Hospital Discharge Surveys (NHDS), I estimate the relationship between malpractice pressure, as identified by the adoption of noneconomic damage caps and related tort reforms, and certain decisions faced by obstetricians during the delivery of a child. The NHDS data, supplemented with restricted geographic identifiers, provides inpatient discharge records from a broad enough span of states and covering a long enough period of time to allow for a defensive medicine analysis that draws on an extensive set of variations in relevant tort laws. Contrary to the conventional wisdom, I find no evidence to support the claim that malpractice pressure induces physicians to perform a substantially greater number of cesarean sections. Extending this analysis to certain additional measures, however, I do find some evidence consistent with positive defensive behavior among obstetricians. For instance, I estimate that the adoption of a noneconomic damage cap is associated with a reduction in the utilization of episiotomies during vaginal deliveries, without a corresponding change in observed neonatal outcomes.

Date: 2012
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https://doi.org/10.1111/j.1740-1461.2012.01259.x

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Persistent link: https://EconPapers.repec.org/RePEc:wly:empleg:v:9:y:2012:i:3:p:457-481

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