Document Detail

Paid malpractice claims for adverse events in inpatient and outpatient settings.
MedLine Citation:
PMID:  21673294     Owner:  NLM     Status:  MEDLINE    
CONTEXT: An analysis of paid malpractice claims may provide insight into the prevalence and seriousness of adverse medical events in the outpatient setting.
OBJECTIVE: To report and compare the number, magnitude, and type of paid malpractice claims for events in inpatient and outpatient settings.
DESIGN AND SETTING: Retrospective analysis of malpractice claims paid on behalf of physicians in outpatient and inpatient settings using data from the National Practitioner Data Bank from 2005 through 2009. We evaluated trends in claims paid by setting, characteristics of paid claims, and factors associated with payment amount.
MAIN OUTCOME MEASURES: Number of paid claims, mean and median payment amounts, types of errors, and outcomes of errors.
RESULTS: In 2009, there were 10,739 malpractice claims paid on behalf of physicians. Of these paid claims, 4910 (47.6%; 95% confidence interval [CI], 46.6%-48.5%) were for events in the inpatient setting, 4448 (43.1%; 95% CI, 42.1%-44.0%) were for events in the outpatient setting, and 966 (9.4%; 95% CI, 8.8%-9.9%) involved events in both settings. The proportion of payments for events in the outpatient setting increased by a small but statistically significant amount, from 41.7% (95% CI, 40.9%-42.6%) in 2005 to 43.1% (95% CI, 42.1%-44.0%) in 2009 (P < .001 for trend across years). In the outpatient setting, the most common reason for a paid claim was diagnostic (45.9%; 95% CI, 44.4%-47.4%), whereas in the inpatient setting the most common reason was surgical (34.1%; 95% CI, 32.8%-35.4%). Major injury and death were the 2 most common outcomes in both settings. Mean payment amount for events in the inpatient setting was significantly higher than in the outpatient setting ($362,965; 95% CI, $348,192-$377,738 vs $290,111; 95% CI, $278,289-$301,934; P < .001).
CONCLUSION: In 2009, the number of paid malpractice claims reported to the National Practitioner Data Bank for events in the outpatient setting was similar to the number in the inpatient setting.
Tara F Bishop; Andrew M Ryan; Andrew K Ryan; Lawrence P Casalino
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  JAMA     Volume:  305     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2011 Jun 
Date Detail:
Created Date:  2011-06-15     Completed Date:  2011-06-16     Revised Date:  2014-09-17    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2427-31     Citation Subset:  AIM; IM    
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MeSH Terms
Aged, 80 and over
Ambulatory Care / legislation & jurisprudence,  statistics & numerical data
Child, Preschool
Cross-Sectional Studies
Diagnostic Techniques and Procedures / adverse effects
Insurance Claim Review
Liability, Legal
Malpractice / economics*,  statistics & numerical data*,  trends
Medical Errors / economics*,  statistics & numerical data
Middle Aged
National Practitioner Data Bank / statistics & numerical data
Outcome Assessment (Health Care)
Physicians / statistics & numerical data*
Retrospective Studies
Surgical Procedures, Operative / adverse effects
United States
Grant Support
K01 HS018546-01/HS/AHRQ HHS
Comment In:
JAMA. 2011 Jun 15;305(23):2464-5   [PMID:  21673301 ]
Erratum In:
JAMA. 2011 Jul 27;306(4):384
Note: Ryan, Andrew K [corrected to Ryan, Andrew M]

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

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