Mathematica Policy Research, 600 Maryland Avenue, S.W., Suite 550, Washington, DC 20024, USA.
Health Serv Res. 2010 Feb;45(1):195-211. doi: 10.1111/j.1475-6773.2009.01062.x. Epub 2009 Nov 19.
This paper examines whether malpractice claims have any impact on obstetrical practice patterns (C-section rates) and physician delivery volume.
Secondary data from the 1992-2000 Florida Hospital Inpatient Discharge File, the Florida Medical Professional Liability Insurance Claims File, and the American Medical Association's Master File on physician characteristics.
The effects of malpractice claims on C-section rates and physician delivery volume were estimated using panel data and a fixed-effects multivariate model.
Variables were constructed from each data source and merged into a single panel dataset using consistent physician identifiers. Principal Findings. I did not find evidence that physicians changed their practice patterns by increasing C-section rates in response to malpractice claims. However, physicians performed six fewer inpatient deliveries 3 years after the closing of a malpractice claim, after controlling for individual- and market-level characteristics. Physicians with high malpractice awards of U.S.$250,000 or more performed 14 fewer deliveries on average.
Malpractice claims led to a small reduction in physician delivery volume, but they did not have a significant impact on C-section rates.
本文旨在探讨医疗事故索赔是否会对产科实践模式（剖宫产率）和医生分娩量产生影响。
1992 年至 2000 年佛罗里达州住院患者出院档案、佛罗里达州医疗专业责任保险索赔档案和美国医师协会医师特征主文件中的二次数据。
使用面板数据和固定效应多元模型来估计医疗事故索赔对剖宫产率和医生分娩量的影响。
从每个数据源构建变量，并使用一致的医师标识符将其合并到一个单一的面板数据集。主要发现。我没有发现证据表明医生会通过增加剖宫产率来应对医疗事故索赔而改变他们的实践模式。然而，在控制了个体和市场特征后，医生在医疗事故索赔结案后 3 年内的住院分娩量减少了 6 次。赔偿金超过 25 万美元的医生的平均分娩量减少了 14 次。
医疗事故索赔导致医生分娩量略有减少，但对剖宫产率没有显著影响。
