First do no harm? Tort reform and birth outcomes
First do no harm? Tort reform and birth outcomes
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DOI：
10.1162/qjec.2008.123.2.795
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发表时间：
2008-05-01
影响因子：
13.7
通讯作者：
Macleod, W. Bentley
中科院分区：
文献类型：
--
作者：
Currie, Janet;Macleod, W. Bentley
在20世纪80年代和90年代，许多州进行了侵权法改革。有人认为，这些改革减少了因过度侵权责任而产生的防御性医疗做法。我们发现，这似乎并不适用于一个大的和重要的类的情况下，分娩在美国。利用1989年至2001年数百万例出生的国家人口动态统计出生率文件的数据，我们询问具体的侵权改革是否会影响所执行的程序类型以及母亲及其婴儿的健康结果。我们发现，连带责任规则（或“深口袋规则”）的改革减少了劳动和程序使用的复杂性，而非经济损失的上限增加了它们。我们表明，这些结果是一致的侵权改革，明确允许患者的条件变化的模型。
In the 1980s and 1990s many states adopted tort reforms. It has been argued that these reforms have reduced the practice of defensive medicine arising from excess tort liability. We find that this does not appear to be true for a large and important class of cases-childbirth in the United States. Using data from national vital statistics natality files on millions of individual births from 1989 to 2001, we ask whether specific tort reforms affect the types of procedures that are performed, and the health outcomes of mothers and their infants. We find that reform of the Joint and Several Liability rule (or the "deep pockets rule") reduces complications of labor and procedure use, whereas caps on noneconomic damages increase them. We show that these results are consistent with a model of tort reform that explicitly allows for variations in patient condition.