From Weill Cornell: Characteristics of paid malpractice claims settled in and out of court in the USA

http://www.ncbi.nlm.nih.gov/pubmed/23794584

BMJ Open. 2013 Jun 20;3(6). pii: e002985. doi: 10.1136/bmjopen-2013-002985. Print 2013.

Characteristics of paid malpractice claims settled in and out of court in the USA: a retrospective analysis.

Rubin JB, Bishop TF.

Source

Weill Cornell Medical College, New York, New York, USA.

Abstract

OBJECTIVE:

An analysis of paid malpractice claims judged in court compared with those settled out of court may help explain perceptions ofmalpractice risk.

DESIGN:

A retrospective analysis and cross-sectional comparison of malpractice claims. Evaluated trends in the number and proportion of paid claims, and mean payment amount by resolution type; identified patient, physician and claim characteristics associated with each resolution type. Examined the effects of resolution type on payment amount and time to claim resolution.

SETTING:

Claims paid on behalf of US physicians reported in the National Practitioner Data Bank (NPDB) from 2005 to 2009.

MAIN OUTCOME MEASURES:

Type of resolution, claim characteristics, payment amount and time to resolution.

RESULTS:

Between 2005 and 2009, there were 58 667 claims paid on behalf of US physicians. Of these paid claims, 56 850 (96.9%) were settled outside court, and 1817 (3.1%) were judged in court. There was no significant change in the proportion of paid claims resolved by settlement versus judgement over time (p=0.83); nor was there a significant change in the mean payment amount in either resolution group (settlement, p=0.94; judgement, p=0.36). The claims in which the physicians were under 50, had prior malpractice reports, which were paid by a state malpracticeprogramme, for adverse events to a fetus, and for surgical or obstetric error were more likely to be judged in court. The mean payment amount (US$592 283 vs US$317 447, p<0.01), per cent of payments over US$1 million (41.82% vs 15.43%, p<0.01), and time to decision (6.50 years vs 4.93 years, p<0.01) were significantly higher in judged claims.

CONCLUSIONS:

Although only a very small percentage of paid malpractice claims in the USA are judged in court, a number of characteristics differ between settled and judged claims. Such differences may influence perceptions of malpractice risk and future reform efforts.