title: The effects of medical liability on obstetric care supply in Michigan.
abstract: OBJECTIVE
  The objective of the study was to examine Michigan obstetric providers' provision of obstetric care and the impact of malpractice concerns on their practice decisions.
  
  
  METHODS
  Data were obtained from 899 Michigan obstetrician-gynecologists, family physicians, and nurse-midwives via a statewide survey. Statistical tests were conducted to examine differences in obstetric care provision and the influence of various factors across specialties.
  
  
  RESULTS
  Among providers currently practicing obstetrics, 18.3%, 18.7%, and 11.9% of obstetrician-gynecologists, family physicians, and nurse-midwives, respectively, planned to discontinue delivering babies in the next 5 years, and 35.5%, 24.5%, and 12.6%, respectively, planned to reduce their provision of high-risk obstetric care. "Risk of malpractice litigation" was 1 of the most cited factors affecting providers' decision to include obstetrics in their practice.
  
  
  CONCLUSIONS
  Litigation risk appears to be an important factor influencing Michigan obstetric providers' decisions about provision of care. Its implications for obstetric care supply and patients' access to care warrants further research.
authors.affiliation: Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA. xiaox@med.umich.edu
authors.forename: Xiao
authors.initials: X
authors.lastname: Xu
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Siefert
authors.forename: Peter D
authors.initials: PD
authors.lastname: Jacobson
authors.forename: Jody R
authors.initials: JR
authors.lastname: Lori
authors.forename: Scott B
authors.initials: SB
authors.lastname: Ransom
mesh_terms: D001291:Attitude of Health Personnel; D003657:Decision Making; D036861:Delivery, Obstetric / Q000191:economics / Q000331:legislation & jurisprudence; D005194:Family Practice / Q000191:economics / Q000331:legislation & jurisprudence; D005260:Female; D006297:Health Services Accessibility / Q000191:economics / Q000639:trends; D006801:Humans; D007351:Insurance, Liability / Q000191:economics*; D016365:Liability, Legal / Q000191:economics*; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence; D008427:Maternal Health Services / Q000191:economics / Q000600:supply & distribution; D008824:Michigan; D008875:Middle Aged; D009721:Nurse Midwives / Q000191:economics / Q000331:legislation & jurisprudence; D009774:Obstetrics / Q000191:economics / Q000331:legislation & jurisprudence*; D011247:Pregnancy; D011364:Professional Practice / Q000191:economics / Q000639:trends; D012306:Risk; D011795:Surveys and Questionnaires; D000078329:Workforce