The impact of malpractice liability claims on obstetrical practice patterns.
OBJECTIVE
This paper examines whether malpractice claims have any impact on obstetrical practice patterns (C-section rates) and physician delivery volume.


METHODS
Secondary data from the 1992-2000 Florida Hospital Inpatient Discharge File, the Florida Medical Professional Liability Insurance Claims File, and the American Medical Association's Master File on physician characteristics.


METHODS
The effects of malpractice claims on C-section rates and physician delivery volume were estimated using panel data and a fixed-effects multivariate model.


METHODS
Variables were constructed from each data source and merged into a single panel dataset using consistent physician identifiers. Principal Findings. I did not find evidence that physicians changed their practice patterns by increasing C-section rates in response to malpractice claims. However, physicians performed six fewer inpatient deliveries 3 years after the closing of a malpractice claim, after controlling for individual- and market-level characteristics. Physicians with high malpractice awards of U.S.$250,000 or more performed 14 fewer deliveries on average.


CONCLUSIONS
Malpractice claims led to a small reduction in physician delivery volume, but they did not have a significant impact on C-section rates.
Gimm
Gilbert W
GW
Mathematica Policy Research, 600 Maryland Avenue, S.W., Suite 550, Washington, DC 20024, USA. ggimm@mathematica-mpr.com
D000328:Adult; D000368:Aged; D002585:Cesarean Section / Q000706:statistics & numerical data; D019992:Databases as Topic; D036861:Delivery, Obstetric / Q000331:legislation & jurisprudence / Q000379:methods; D005431:Florida; D006801:Humans; D007345:Insurance Claim Review; D016365:Liability, Legal / Q000191:economics*; D008318:Malpractice / Q000191:economics*; D008875:Middle Aged; D009774:Obstetrics / Q000191:economics / Q000331:legislation & jurisprudence* / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000639:trends*