Malpractice law and health care reform: optimal liability policy in an era of managed care
Malpractice law and health care reform: optimal liability policy in an era of managed care
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DOI：
10.1016/s0047-2727(01)00124-4
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发表时间：
2002-05-01
影响因子：
9.8
通讯作者：
McClellan, M
中科院分区：
文献类型：
--
作者：
Kessler, D;McClellan, M
由于按服务收费的医疗保险使提供者不承担治疗决定的费用，因此可能导致“防御性医疗”——由于担心承担法律责任，预防性治疗的预期医疗效益最低。通过给予提供者更有力的激励，管理式医疗可能会影响最优责任政策。在1984-1994年患有心脏病的老年医疗保险受益人中，我们发现减少责任的“侵权改革”减少了管理医疗登记人数高低的地区的防御行为，但管理医疗和责任改革是替代的。我们考虑这些结果的一些含义，为当前的争论是否适当扩大医疗事故责任管理护理组织。(C) 2002 Elsevier Science BV版权所有
Because fee-for-service health insurance insulates providers from the costs of treatment decisions, it may lead to "defensive medicine" - precautionary treatment with minimal expected medical benefit administered out of fear of legal liability. By giving providers higher-powered incentives, managed care may affect optimal liability policy. Among elderly Medicare beneficiaries with heart disease in 1984-1994, we find that liability-reducing "tort reforms" reduce defensive practices in areas with high and low managed care enrollment, but that managed care and liability reform are substitutes. We consider some implications of these results for the current debate over the appropriateness of extending malpractice liability to managed care organizations. (C) 2002 Elsevier Science BV All rights reserved.