Economic Issues in Medical Malpractice: Dispute Resolution and the Shift to No-Fault

医疗事故是病人对医疗保健质量的关切与利用法律补救所感知到的委屈的交集。当病人对所接受的医疗服务质量不满意时，他们可以到医院投诉或提起诉讼。如果他们提出投诉，医院的投诉办公室可以通过以下方式作出回应：为个人提供一个表达不满的论坛，以宽恕患者未付账单的形式提供补偿，或提供现金补偿。如果提出赔偿建议，病人可以选择接受或拒绝，在这种情况下，他可以提起医疗事故诉讼。如果没有提出赔偿，患者可以选择提起诉讼或不再采取进一步行动。迄今为止，很少有研究试图审查投诉如何演变成和解，并演变成医疗事故诉讼。怀特博士将填补医疗事故研究的这一空白，他将收集在某家医院登记的投诉的丰富数据集，并将其与来自同一来源的有关医疗事故诉讼的现有数据集合并。利用合并的数据集，将构建模型来分析是什么决定了投诉是否演变为诉讼，评估哪一方从早期解决争议中获益最大，并估计在争议管理过程的投诉阶段，疏忽是否影响确定医院的预期责任。项目的这一阶段应提供对诉讼前争端解决程序的一般见解，以及争端处理的早期阶段如何影响申诉演变为解决或诉讼。利用模拟方法，该项目的第二阶段调查了从目前的医疗事故责任制度转向假设的无过错制度的成本和收益。该项目的这一阶段将调查一系列重要的政策问题，包括估计转向无过失对支付的赔偿总额和管理赔偿制度的费用的影响。

Medical malpractice represents the intersection of patient concerns about the quality of medical care with the use of law to redress a perceived grievance. When patients are dissatisfied with the quality of the medical care they receive, they can either register a complaint at a hospital or file a lawsuit. If they register a complaint, the hospital's complaints office may respond by offering a forum for an individual to air a grievance, providing compensation in the form of forgiveness of a patient's outstanding bill, or by offering cash compensation. If an offer of compensation is made, the patient has a choice between accepting the offer or rejecting it, in which case (s)he may file a medical malpractice lawsuit. If no offer of compensation is made, the patient has a choice between filing a lawsuit or taking no further action. To date, very little research has been completed which seeks to examine how complaints evolve into settlements, and into medical malpractice lawsuits. Dr. White will fill this gap in medical malpractice research by collecting a rich set of data on complaints registered in a specific hospital and merging it with an existing data set concerning medical malpractice lawsuits from the same source. Utilizing the merged data set, models will be constructed to analyze what determines whether complaints evolve into lawsuits, assess which side benefits most from resolving disputes early, and estimate whether negligence matters in determining the hospital's expected liability at the complaint stage of the dispute management process. This phase of the project should provide considerable insight into the pre-litigation dispute resolution process in general and how the early stages of dispute processing influence the evolution of complaints into settlements or into lawsuits. Using a simulation approach, the second phase of the project investigates the costs and benefits of shifting from the current system of liability in medical malpractice to a hypothetical no- fault system. This phase of the project will investigate a series of important policy questions, including an estimate of the effect of a shift to no-fault on the level of total compensation paid and the cost of administering the compensation system.