Do Doctors Practice Defensive Medicine?

Daniel P. Kessler, M. Mcclellan
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引用次数: 647

Abstract

`Defensive medicine' is a potentially serious social problem: if fear of liability drives health care providers to administer treatments that do not have worthwhile medical benefits, then the current liability system may generate inefficiencies many times greater than the costs of compensating malpractice claimants. To obtain direct empirical evidence on this question, we analyze the effects of malpractice liability reforms using data on all elderly Medicare beneficiaries treated for serious heart disease in 1984, 1987, and 1990. We find that malpractice reforms that directly reduce provider liability pressure lead to reductions of 5 to 9 percent in medical expenditures without substantial effects on mortality or medical complications. We conclude that liability reforms can reduce defensive medical practices.
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医生会进行防御性医疗吗?
“防御性医疗”是一个潜在的严重社会问题:如果对责任的恐惧驱使医疗保健提供者实施没有价值的医疗效益的治疗,那么目前的责任制度可能产生的效率低下比赔偿医疗事故索赔人的成本高出许多倍。为了获得关于这个问题的直接经验证据,我们使用1984年、1987年和1990年因严重心脏病而接受治疗的所有老年医疗保险受益人的数据,分析了医疗事故责任改革的影响。我们发现,医疗事故改革直接减少了提供者的责任压力,导致医疗支出减少了5%至9%,而对死亡率或医疗并发症没有实质性影响。我们得出结论,责任改革可以减少防御性医疗实践。
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