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Does Medical Malpractice Law Improve Health Care Quality?

Michael Frakes and Anupam Jena

No 19841, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: Despite the fundamental role of deterrence in justifying a system of medical malpractice law, surprisingly little evidence has been put forth to date bearing on the relationship between medical liability forces on the one hand and medical errors and health care quality on the other. In this paper, we estimate this relationship using clinically validated measures of health care treatment quality constructed with data from the 1979 to 2005 National Hospital Discharge Surveys and the 1987 to 2008 Behavioral Risk Factor Surveillance System records. Drawing upon traditional, remedy-centric tort reforms--e.g., damage caps--we estimate that the current liability system plays at most a modest role in inducing higher levels of health care quality. We contend that this limited independent role for medical liability may be a reflection upon the structural nature of the present system of liability rules, which largely hold physicians to standards determined according to industry customs. We find evidence suggesting, however, that physician practices may respond more significantly upon a substantive alteration of this system altogether--i.e., upon a change in the clinical standards to which physicians are held in the first instance. The literature to date has largely failed to appreciate the substantive nature of liability rules and may thus be drawing limited inferences based solely on our experiences to date with damage-caps and related reforms.

JEL-codes: I18 K13 (search for similar items in EconPapers)
Date: 2014-01
New Economics Papers: this item is included in nep-hea and nep-law
Note: EH LE
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Citations: View citations in EconPapers (8)

Published as Michael Frakes & Anupam B. Jena, 2016. "Does medical malpractice law improve health care quality?," Journal of Public Economics, vol 143, pages 142-158.

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