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Is there empirical evidence for "Defensive Medicine"? A reassessment.

Publication ,  Journal Article
Sloan, FA; Shadle, JH
Published in: Journal of health economics
March 2009

Proponents of tort reform applied to medical malpractice argue for change partly on the premise that the threat of lawsuits has made medical care more costly. Using U.S. longitudinal data from the National Long-Term Care Survey merged with Medicare claims and other data for 1985-2000, this study assesses whether tort reforms have reduced Medicare payments made on behalf of beneficiaries and the survival probability following an index event. Direct reforms (caps on damages, abolition of punitive damages, eliminating mandatory prejudgment interest, and collateral source offset) did not significantly reduce payments for Medicare-covered services in any specification. Indirect reforms (limitations on contingency fees, mandatory periodic payments, joint-and-several liability reform, and patient compensation funds) significantly reduced Medicare payments only in a specification based on any hospitalization, but not in analysis of hospitalization for each of four common chronic conditions. Neither direct nor indirect reforms had a significant effect on the health outcomes, with one exception. The overall conclusion is that tort reforms do not significantly affect medical decisions, nor do they have a systematic effect on patient outcomes.

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Published In

Journal of health economics

DOI

EISSN

1879-1646

ISSN

0167-6296

Publication Date

March 2009

Volume

28

Issue

2

Start / End Page

481 / 491

Related Subject Headings

  • United States
  • Medicare
  • Malpractice
  • Male
  • Longitudinal Studies
  • Insurance Claim Review
  • Humans
  • Health Policy & Services
  • Health Care Reform
  • Female
 

Citation

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Sloan, F. A., & Shadle, J. H. (2009). Is there empirical evidence for "Defensive Medicine"? A reassessment. Journal of Health Economics, 28(2), 481–491. https://doi.org/10.1016/j.jhealeco.2008.12.006
Sloan, Frank A., and John H. Shadle. “Is there empirical evidence for "Defensive Medicine"? A reassessment.Journal of Health Economics 28, no. 2 (March 2009): 481–91. https://doi.org/10.1016/j.jhealeco.2008.12.006.
Sloan FA, Shadle JH. Is there empirical evidence for "Defensive Medicine"? A reassessment. Journal of health economics. 2009 Mar;28(2):481–91.
Sloan, Frank A., and John H. Shadle. “Is there empirical evidence for "Defensive Medicine"? A reassessment.Journal of Health Economics, vol. 28, no. 2, Mar. 2009, pp. 481–91. Epmc, doi:10.1016/j.jhealeco.2008.12.006.
Sloan FA, Shadle JH. Is there empirical evidence for "Defensive Medicine"? A reassessment. Journal of health economics. 2009 Mar;28(2):481–491.
Journal cover image

Published In

Journal of health economics

DOI

EISSN

1879-1646

ISSN

0167-6296

Publication Date

March 2009

Volume

28

Issue

2

Start / End Page

481 / 491

Related Subject Headings

  • United States
  • Medicare
  • Malpractice
  • Male
  • Longitudinal Studies
  • Insurance Claim Review
  • Humans
  • Health Policy & Services
  • Health Care Reform
  • Female