Document Detail


Malpractice risk and cost are significantly reduced after tort reform.
MedLine Citation:
PMID:  21463769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Rising medical malpractice premiums have reached a crisis point in many areas of the United States. In 2003 the Texas legislature passed a comprehensive package of tort reform laws that included a cap at $250,000 on noneconomic damages in most medical malpractice cases. We hypothesized that tort reform laws significantly reduce the risk of malpractice lawsuit in an academic medical center. We compared malpractice prevalence, incidence, and liability costs before and after comprehensive state tort reform measures were implemented.
STUDY DESIGN: Two prospectively maintained institutional databases were used to calculate and characterize malpractice risk: a surgical operation database and a risk management and malpractice database. Risk groups were divided into pretort reform (1992 to 2004) and post-tort reform groups (2004 to the present). Operative procedures were included for elective, urgent, and emergency general surgery procedures.
RESULTS: During the study period, 98,513 general surgical procedures were performed. A total of 28 lawsuits (25 pre-reform, 3 postreform) were filed, naming general surgery faculty or residents. The prevalence of lawsuits filed/100,000 procedures performed is as follows: before reform, 40 lawsuits/100,000 procedures, and after reform, 8 lawsuits/100,000 procedures (p < 0.01, relative risk 0.21 [95% CI 0.063 to 0.62]). Virtually all of the liability and defense cost was in the pretort reform period: $595,000/year versus $515/year in the postreform group (p < 0.01).
CONCLUSIONS: Implementation of comprehensive tort reform in Texas was associated with a significant decrease in the prevalence and cost of surgical malpractice lawsuits at one academic medical center.
Authors:
Ronald M Stewart; Kathy Geoghegan; John G Myers; Kenneth R Sirinek; Michael G Corneille; Deborah Mueller; Daniel L Dent; Steven E Wolf; Basil A Pruitt
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Surgeons     Volume:  212     ISSN:  1879-1190     ISO Abbreviation:  J. Am. Coll. Surg.     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-05     Completed Date:  2011-06-28     Revised Date:  2011-10-05    
Medline Journal Info:
Nlm Unique ID:  9431305     Medline TA:  J Am Coll Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  463-7, 467.e1-42; discussion 467-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2011. Published by Elsevier Inc.
Affiliation:
Department of Surgery, University of Texas Health Science Center at San Antonio, and University Hospital, San Antonio, TX 78229, USA. stewartr@uthscsa.edu
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MeSH Terms
Descriptor/Qualifier:
Academic Medical Centers
Cohort Studies
General Surgery / organization & administration*
Health Care Reform / organization & administration*
Humans
Insurance, Liability / economics*,  legislation & jurisprudence
Liability, Legal / economics*
Malpractice / economics*,  legislation & jurisprudence,  statistics & numerical data*
Retrospective Studies
Texas
Comments/Corrections
Comment In:
J Am Coll Surg. 2011 Sep;213(3):454; author reply 455   [PMID:  21871388 ]

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


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