• Most preventable medical errors do not result in a paid claim

    Paid physician malpractice claims for adverse events in 2009 (from Bishop, Ryan & Casalino in this week’s JAMA):

    Inpatient4910
    Outpatient4448
    Both966
    Total10,739

    By way of comparison (my calculations):

    Incidence
    Number of US hospitals5,795<1 per hospital/year
    Number of admissions37,479,7090.00014/admission
    Number of US physicians661,4000.01624/physician/year
    Medical error deaths(preventable, IOM)44,0004.1 deaths/paid claim
    98,0009.1 deaths/paid claim

    4.1 to 9.1 deaths per paid claim has strong implications for medical apology laws (now proposed in MA). Studdert, Mello, Gawande, Brennan and Wang (health policy All-Stars) raised this question in Health Affairs back in 2007. The key assumption is to what extent apologies will prompt litigation from patients who don’t sue today.

    updated: typos

     
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    • Most medical errors do not result in a lawsuit or compensation to patients. Some years ago there was a proposal for a “no fault” medical malpractice scheme but this was scrapped when people figured out that they would be compensating many more claims than the current adversarial system.
      Real medical malpractice reform would actually compensate patients reasonably for medical errors and would probably drastically increase costs.

    • Of course, most avoidable errors do result in a paid claim in another sense: they doctor gets paid for services and there is no rebate.

    • Medical errors should be prevented to be able to decline the rate of Medical malpractice. It will therefore enhance the healthcare system.