title: How does routine disclosure of medical error affect patients' propensity to sue and their assessment of provider quality? Evidence from survey data.
abstract: BACKGROUND
  Although strongly favored by patients and ethically imperative for providers, the disclosure of medical errors to patients remains rare because providers fear that it will trigger lawsuits and jeopardize their reputation. To date little is known how patients might respond to their providers' disclosure of a medical error even when paired with an offer of remediation.
  
  
  METHODS
  A representative sample of Illinois residents was surveyed in 2008 about their knowledge about medical errors, their confidence that their providers would disclose medical errors to them, and their propensity to sue and recommend providers that disclose medical errors and offer to remedy them. We report the response patterns to these questions. As robustness checks, we also estimate the covariate-adjusted distributions and test the associations among these dimensions of medical-error disclosure.
  
  
  RESULTS
  Of the 1018 respondents, 27% would sue and 38% would recommend the hospital after medical error disclosure with an accompanying offer of remediation. Compared with the least confident respondents, those who were more confident in their providers' commitment to disclose were not likely to sue but significantly and substantially more likely to recommend their provider.
  
  
  CONCLUSIONS
  Patients who are confident in their providers' commitment to disclose medical errors are not more litigious and far more forgiving than patients who have no faith in their providers' commitment to disclose.
authors.affiliation: School of Public Health, Division of Health Policy and Administration, University of Illinois, Chicago, IL, USA. helmchen@uic.edu
authors.forename: Lorens A
authors.initials: LA
authors.lastname: Helmchen
authors.forename: Michael R
authors.initials: MR
authors.lastname: Richards
authors.forename: Timothy B
authors.initials: TB
authors.lastname: McDonald
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003219:Confidentiality; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D008297:Male; D008318:Malpractice / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D019300:Medical Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D010817:Physician-Patient Relations; D011159:Population Surveillance; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035502:Trust; D014342:Truth Disclosure; D055815:Young Adult