Document Detail


Liability claims and costs before and after implementation of a medical error disclosure program.
MedLine Citation:
PMID:  20713789     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Since 2001, the University of Michigan Health System (UMHS) has fully disclosed and offered compensation to patients for medical errors. OBJECTIVE: To compare liability claims and costs before and after implementation of the UMHS disclosure-with-offer program. DESIGN: Retrospective before-after analysis from 1995 to 2007. SETTING: Public academic medical center and health system. PATIENTS: Inpatients and outpatients involved in claims made to UMHS. MEASUREMENTS: Number of new claims for compensation, number of claims compensated, time to claim resolution, and claims-related costs. RESULTS: After full implementation of a disclosure-with-offer program, the average monthly rate of new claims decreased from 7.03 to 4.52 per 100,000 patient encounters (rate ratio [RR], 0.64 [95% CI, 0.44 to 0.95]). The average monthly rate of lawsuits decreased from 2.13 to 0.75 per 100,000 patient encounters (RR, 0.35 [CI, 0.22 to 0.58]). Median time from claim reporting to resolution decreased from 1.36 to 0.95 years. Average monthly cost rates decreased for total liability (RR, 0.41 [CI, 0.26 to 0.66]), patient compensation (RR, 0.41 [CI, 0.26 to 0.67]), and non-compensation-related legal costs (RR, 0.39 [CI, 0.22 to 0.67]). LIMITATIONS: The study design cannot establish causality. Malpractice claims generally declined in Michigan during the latter part of the study period. The findings might not apply to other health systems, given that UMHS has a closed staff model covered by a captive insurance company and often assumes legal responsibility. CONCLUSION: The UMHS implemented a program of full disclosure of medical errors with offers of compensation without increasing its total claims and liability costs. PRIMARY FUNDING SOURCE: Blue Cross Blue Shield of Michigan Foundation.
Authors:
Allen Kachalia; Samuel R Kaufman; Richard Boothman; Susan Anderson; Kathleen Welch; Sanjay Saint; Mary A M Rogers
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Annals of internal medicine     Volume:  153     ISSN:  1539-3704     ISO Abbreviation:  Ann. Intern. Med.     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-17     Completed Date:  2010-09-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372351     Medline TA:  Ann Intern Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  213-21     Citation Subset:  AIM; IM    
Affiliation:
Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. akachalia@partners.org
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MeSH Terms
Descriptor/Qualifier:
Academic Medical Centers / economics,  organization & administration
Compensation and Redress*
Costs and Cost Analysis
Disclosure*
Humans
Insurance Claim Review / statistics & numerical data
Liability, Legal / economics*
Medical Errors / economics*,  legislation & jurisprudence
Michigan
Organizational Policy
Program Evaluation
Retrospective Studies
Grant Support
ID/Acronym/Agency:
R01-NR010700/NR/NINR NIH HHS; R21-DK078717/DK/NIDDK NIH HHS
Comments/Corrections
Comment In:
Ann Intern Med. 2010 Aug 17;153(4):266-7   [PMID:  20713794 ]
Summary for patients in:
Ann Intern Med. 2010 Aug 17;153(4):I-28   [PMID:  20713776 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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