The impact of malpractice fears on cesarean section rates

A longstanding issue in the health care industry is whether physicians' malpractice fears lead to defensive medicine. We use national birth certificate data from 1990 through 1992 to conduct a county fixed-effects analysis of the impact of malpractice claims risk on cesarean-section rates and i...

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Bibliographic Details
Published in:Journal of health economics 1999-08, Vol.18 (4), p.491-522
Main Authors: Dubay, Lisa, Kaestner, Robert, Waidmann, Timothy
Format: Article
Language:English
Subjects:
Birth
Births
Cesarean section
Cesarean Section - utilization
Child health
Defensive Medicine
Female
Health administration
Health care
Health Services Misuse
Humans
Malpractice
Malpractice - statistics & numerical data
Mathematical economics
Medical malpractice
Models, Statistical
Practice Patterns, Physicians
Pregnancy
Risk
Risk Assessment
Social Class
Socioeconomic status
Statistical analysis
Statistics
Studies
United States
Women's health
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Summary:A longstanding issue in the health care industry is whether physicians' malpractice fears lead to defensive medicine. We use national birth certificate data from 1990 through 1992 to conduct a county fixed-effects analysis of the impact of malpractice claims risk on cesarean-section rates and infant health. Malpractice claims risk is measured by obstetricians' malpractice premiums. The study provides evidence that physicians practice defensive medicine in obstetrics but that the impact of increased cesarean sections that results from malpractice fears on total obstetric care costs is small. The study also finds that physicians' defensive response varies with the socioeconomic status of the mother.
ISSN:0167-6296
1879-1646
DOI:10.1016/S0167-6296(99)00004-1