NATIONAL BUREAU OF ECONOMIC RESEARCH
NATIONAL BUREAU OF ECONOMIC RESEARCH

Does Medical Malpractice Law Improve Health Care Quality?

Michael Frakes, Anupam B. Jena

NBER Working Paper No. 19841
Issued in January 2014
NBER Program(s):   HC   HE   LE

Despite the fundamental role of deterrence in justifying a system of medical malpractice law, surprisingly little evidence has been put forth to date bearing on the relationship between medical liability forces on the one hand and medical errors and health care quality on the other. In this paper, we estimate this relationship using clinically validated measures of health care treatment quality constructed with data from the 1979 to 2005 National Hospital Discharge Surveys and the 1987 to 2008 Behavioral Risk Factor Surveillance System records. Drawing upon traditional, remedy-centric tort reforms--e.g., damage caps--we estimate that the current liability system plays at most a modest role in inducing higher levels of health care quality. We contend that this limited independent role for medical liability may be a reflection upon the structural nature of the present system of liability rules, which largely hold physicians to standards determined according to industry customs. We find evidence suggesting, however, that physician practices may respond more significantly upon a substantive alteration of this system altogether--i.e., upon a change in the clinical standards to which physicians are held in the first instance. The literature to date has largely failed to appreciate the substantive nature of liability rules and may thus be drawing limited inferences based solely on our experiences to date with damage-caps and related reforms.

download in pdf format
   (709 K)

email paper

A non-technical summary of this paper is available in the May 2014 NBER digest.  You can sign up to receive the NBER Digest by email.

The NBER Bulletin on Aging and Health provides summaries of publications like this.  You can sign up to receive the NBER Bulletin on Aging and Health by email.

This paper is available as PDF (709 K) or via email.

A data appendix is available at http://www.nber.org/data-appendix/w19841

Machine-readable bibliographic record - MARC, RIS, BibTeX

Document Object Identifier (DOI): 10.3386/w19841

Users who downloaded this paper also downloaded these:
Greenwood, Guner, Kocharkov, and Santos w19829 Marry Your Like: Assortative Mating and Income Inequality
Dobbie and Fryer w19581 The Medium-Term Impacts of High-Achieving Charter Schools on Non-Test Score Outcomes
Horwitz and Polsky w19801 Cross Border Effects of State Health Technology Regulation
Gaynor, Ho, and Town w19800 The Industrial Organization of Health Care Markets
von Hinke Kessler Scholde, Wehby, Lewis, and Zuccolo w19839 Alcohol Exposure In Utero and Child Academic Achievement
 
Publications
Activities
Meetings
NBER Videos
Data
People
About

Support
National Bureau of Economic Research, 1050 Massachusetts Ave., Cambridge, MA 02138; 617-868-3900; email: info@nber.org

Contact Us