How liability law affects medical productivity
How liability law affects medical productivity
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DOI：
10.1016/s0167-6296(02)00076-0
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发表时间：
2002-11-01
影响因子：
3.5
通讯作者：
McClellan, MB
中科院分区：
文献类型：
--
作者：
Kessler, DP;McClellan, MB
先前的研究表明，对责任体系的“直接”改革旨在降低潜在索赔人的赔偿水平的改革减少了医疗支出，但对患者的健康结果没有重要影响。我们通过确定改革影响医疗服务提供者行为的机制来扩展这项研究。虽然我们发现，直接改革提高医疗生产力主要是通过降低医疗事故索赔率和赔偿条件的索赔，我们的研究结果表明，其他政策，减少所花费的时间和冲突的金额，在捍卫对索赔也可以大大减少防御性的做法。此外，我们发现，“医疗事故的压力”有更显着的影响，而不是诊断治疗的决定。我们的研究结果提供了一个实证基础，模拟未经尝试的医疗事故改革对医疗保健支出和结果的影响，基于他们对医疗服务提供者面临的医疗事故压力的预测影响，（C）2002年爱思唯尔科学有限公司版权所有。
Previous research suggests that "direct" reforms to the liability system-reforms designed to reduce the level of compensation to potential claimants-reduce medical expenditures without important consequences for patient health outcomes. We extend this research by identifying the mechanisms through which reforms affect the behavior of health care providers. Although we find that direct reforms improve medical productivity primarily by reducing malpractice claims rates and compensation conditional on a claim, our results suggest that other policies that reduce the time spent and the amount of conflict involved in defending against a claim can also reduce defensive practices substantially. In addition, we find that "malpractice pressure" has a more significant impact on diagnostic rather than therapeutic treatment decisions. Our results provide an empirical foundation for simulating the effects of untried malpractice reforms on health care expenditures and outcomes, based on their predicted effects on the malpractice pressure facing medical providers, (C) 2002 Elsevier Science B.V. All rights reserved.