Defensive Medicine: Evidence from Military Immunity
Defensive Medicine: Evidence from Military Immunity
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DOI：
10.1257/pol.20180167
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发表时间：
2019-08-01
影响因子：
5.3
通讯作者：
Gruber, Jonathan
中科院分区：
文献类型：
--
作者：
Frakes, Michael;Gruber, Jonathan
我们估计医生的防御性医疗的程度，拥抱无责任反事实的责任规则在军事卫生系统的结构。在军事设施寻求治疗的现役病人不能就疏忽照顾造成的伤害提起诉讼，而在军事设施接受治疗的家属以及在民用设施接受照顾的所有现役或非现役病人都得到保护。借鉴这种变化，并利用外源性冲击，以照顾位置的选择源于基层医院关闭，我们发现暗示性的证据表明，责任豁免减少住院费用的5%，对病人的结果没有可测量的负面影响。
We estimate the extent of defensive medicine by physicians, embracing the no-liability counterfactual made possible by the structure of liability rules in the Military Health System. Active-duty patients seeking treatment from military facilities cannot sue for harms resulting from negligent care, while protections are provided to dependents treated at military facilities and to all patients active duty or not that receive care from civilian facilities. Drawing on this variation and exploiting exogenous shocks to care location choices stemming from base-hospital closures, we find suggestive evidence that liability immunity reduces inpatient spending by 5 percent with no measurable negative effect on patient outcomes.