Accidents, claiming, and regional subcultures: are medical errors and malpractice lawsuits related to social capital?
METHODS
This study examined states' performance on Patient Safety Indicators (PSIs), statistics on malpractice lawsuits, and analogous data on automobile accidents to identify state-level patterns in safety and claiming.


RESULTS
Hospital safety varied in a pattern similar to highway safety on the state level, suggesting that cultural traits may play a greater role than differences in legal or other environmental factors. States performing well or poorly in hospital and driver safety tended to correspond with states grouped together in regional culture typologies developed by Elazar and Lieske. Traits of regional culture also are associated with variations in tort claiming.


CONCLUSIONS
The paper offers a theory of social capital as an important factor affecting safety and tort claiming. Where the regional culture is one of high cohesion and trust, people may exercise a higher degree of caution and vigilance in their interaction with others, and feel less inclination to file lawsuits subsequent to accidents.
AARP Public Policy Institute, 601 E Street, NW, Washington, DC 20049, USA. jtwilliams@aarp.org
Jackson
J
Williams
D000063:Accidents, Traffic / Q000331:legislation & jurisprudence*; D003431:Cross-Cultural Comparison; D006801:Humans; D016365:Liability, Legal; D008318:Malpractice / Q000331:legislation & jurisprudence*; D019300:Medical Errors / Q000331:legislation & jurisprudence*; D012961:Sociology; D035502:Trust; D014481:United States