Does Medical Malpractice Law Improve Health Care Quality?

53 Pages Posted: 25 Jan 2014 Last revised: 31 Jan 2014

See all articles by Michael Frakes

Michael Frakes

Duke University School of Law

Anupam B. Jena

Harvard University; National Bureau of Economic Research (NBER)

Multiple version iconThere are 2 versions of this paper

Date Written: January 2014

Abstract

Despite the fundamental role of deterrence in justifying a system of medical malpractice law, surprisingly little evidence has been put forth to date bearing on the relationship between medical liability forces on the one hand and medical errors and health care quality on the other. In this paper, we estimate this relationship using clinically validated measures of health care treatment quality constructed with data from the 1979 to 2005 National Hospital Discharge Surveys and the 1987 to 2008 Behavioral Risk Factor Surveillance System records. Drawing upon traditional, remedy-centric tort reforms--e.g., damage caps--we estimate that the current liability system plays at most a modest role in inducing higher levels of health care quality. We contend that this limited independent role for medical liability may be a reflection upon the structural nature of the present system of liability rules, which largely hold physicians to standards determined according to industry customs. We find evidence suggesting, however, that physician practices may respond more significantly upon a substantive alteration of this system altogether--i.e., upon a change in the clinical standards to which physicians are held in the first instance. The literature to date has largely failed to appreciate the substantive nature of liability rules and may thus be drawing limited inferences based solely on our experiences to date with damage-caps and related reforms.

Suggested Citation

Frakes, Michael and Jena, Anupam B., Does Medical Malpractice Law Improve Health Care Quality? (January 2014). NBER Working Paper No. w19841. Available at SSRN: https://ssrn.com/abstract=2384298

Michael Frakes

Duke University School of Law ( email )

210 Science Drive
Box 90362
Durham, NC 27708
United States

Anupam B. Jena

Harvard University ( email )

1875 Cambridge Street
Cambridge, MA 02138
United States

National Bureau of Economic Research (NBER) ( email )

1050 Massachusetts Avenue
Cambridge, MA 02138
United States

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