Seabury Seth A, Helland Eric, Jena Anupam B
Seth A. Seabury (
Eric Helland is a professor of economics at Claremont McKenna College, in Claremont, and the RAND Corporation in Santa Monica, both in California.
Health Aff (Millwood). 2014 Nov;33(11):2048-56. doi: 10.1377/hlthaff.2014.0492. Epub 2014 Oct 22.
The impact of medical malpractice reforms on the average size of malpractice payments in specific physician specialties is unknown and subject to debate. We analyzed a national sample of malpractice claims for the period 1985-2010, merged with information on state liability reforms, to estimate the impact of state noneconomic damages caps on average malpractice payment size for physicians overall and for ten different specialty categories. We then compared how the effects differed according to the restrictiveness of the cap ($250,000 versus $500,000). We found that, overall, noneconomic damages caps reduced average payments by $42,980 (15 percent), compared to having no cap at all. A more restrictive $250,000 cap reduced average payments by $59,331 (20 percent), and a less restrictive $500,000 cap had no significant effect, compared to no cap at all. The effect of the caps overall varied according to specialty, with the largest impact being on claims involving pediatricians and the smallest on claims involving surgical subspecialties and ophthalmologists.
医疗事故改革对特定医生专业领域医疗事故赔偿的平均规模的影响尚不清楚，且存在争议。我们分析了1985年至2010年期间全国范围内的医疗事故索赔样本，并结合了各州责任改革的信息，以估计各州非经济损害赔偿上限对医生总体以及十个不同专业类别的医疗事故赔偿平均规模的影响。然后，我们比较了根据赔偿上限的严格程度（25万美元与50万美元）影响有何不同。我们发现，总体而言，与完全没有赔偿上限相比，非经济损害赔偿上限使平均赔偿额减少了42,980美元（15%）。与完全没有赔偿上限相比，更为严格的25万美元赔偿上限使平均赔偿额减少了59,331美元（20%），而限制较小的50万美元赔偿上限则没有显著影响。赔偿上限的总体影响因专业而异，对涉及儿科医生的索赔影响最大，对涉及外科亚专科医生和眼科医生的索赔影响最小。
