Article Figures & Data
Tables
State Average Malpractice Payment ($) Total Payments 1999–2001 ($) Payment per Person* ($) Payments per 1,000 Physicians† No. Payments per 100,000 Population‡ No. * Mean payment amount per person in general population in each state (2000 Census Bureau Data). † Number of payments per 1,000 practicing physicians in each state (AMA 2000 Masterfile). ‡ Number of payments per general population in each state (2000 Census Bureau Data). Michigan 113,695 243,762,850 24.53 89.28 21.57 Kansas 150,592 68,670,050 25.54 80.32 16.96 California 151,744 647,035,900 19.10 56.44 12.59 Nebraska 160,882 35,233,100 20.59 60.13 12.80 New Mexico 172,666 54,389,750 29.90 85.32 17.32 Alabama 379,261 72,818,100 16.37 22.26 4.32 Massachusetts 382,324 343,709,250 54.14 39.95 14.16 Illinois 418,087 664,341,000 53.49 51.10 12.79 Connecticut 472,984 222,775,300 65.42 44.08 13.83 District of Columbia 560,059 104,731,000 183.08 53.69 32.69 States Payments per 1,000 Physicians* No. Payments per 100,000 Population† No. Average Malpractice Payment ($) Payment per Physician‡ ($) Payment per Person§ ($) *Number of payments per 1,000 practicing physicians in those states (AMA 2000 Masterfile). †Number of payments per general population in those states (2000 Census Bureau Data). ‡ Total payment dollar amount per number of practicing physicians in those states (AMA 2000 Masterfile). § Total payment dollar amount per general population in those states (2000 Census Bureau). States with total caps (n = 7) Median 60.13 12.80 190,174.62 10,833.56 20.95 Mean 60.58 12.86 196,495.34 11,504.69 24.38 States without total caps (n = 44) Median 55.06 12.74 248,349.27 13,629.10 30.55 Mean 61.05 14.40 265,554.50 15,501.78 38.73 P value for mean differences .958 .451 .001 .015 .006 States Payments per 1,000 Physicians* No. Payments per 100,000 Population† No. Average Malpractice Payment ($) Payment per Physician‡ ($) Payment per Person§ ($) *Number of payments per 1,000 practicing physicians in those states (AMA 2000 Masterfile). †Number of payments per general population in those states (2000 Census Bureau Data). ‡ Total payment dollar amount per number of practicing physicians in those states (AMA 2000 Masterfile). § Total payment dollar amount per general population in those states (2000 Census Bureau Data). States with noneconomic caps (n = 20) Median 56.79 13.38 217,406.03 11,464.87 25.79 Mean 62.74 13.84 219,225.98 12,711.68 28.60 States without noneconomic caps (n = 31) Median 54.08 12.65 254,058.74 16,940.11 31.25 Mean 59.85 14.42 279,849.86 16,399.28 42.02 P value .691 .776 .010 .028 .047 - Table 4.
Mean Annual Premiums by Specialty for States With and Without Total and Noneconomic Caps, 2000
Specialty States With Total Caps (n = 7) $ States Without Total Caps (n = 44) $ P Values States With Noneconomic Caps (n = 20) $ States Without Noneconomic Caps (n = 31) $ P Values Internal medicine 4,519.86 7,447.00 .015 6,461.65 7,421.74 .427 General surgery 16,912.14 24,516.93 .051 22,244.62 24,092.16 .665 Obstetrics 22,371.57 42,728.68 .001 36,051.81 42,171.97 .371 - Table 5.
Mean Annual Premiums by Specialty for States With and Without Hard or Soft Noneconomic Caps, 2000
P Values† Specialty States With Hard Noneconomic Caps* (n = 12) $ States With Soft Noneconomic Caps* (n = 8) $ States Without Noneconomic Caps (n = 31) $ Hard vs Soft Caps Hard vs No Caps Note: P values for soft vs no caps >.1. * Hard caps = caps without any exceptions; soft caps = caps with exceptions. † Mann-Whitney U test for hard vs soft caps and hard vs no caps. Internal medicine 5,814.75 7,432.00 7,421.74 .157 .430 General surgery 20,653.08 25,304.50 24,092.16 .157 .446 Obstetrics 30,283.75 45,740.88 42,171.97 .039 .081
Additional Files
Supplemental Appendix and Table
Supplemental Appendix 1. Definitions of 10 Common Tort Reform Statutes; Supplemental Table 1. Payments Made to Settle or Satisfy Judgement in a Medical Malpractice Action for Years 1999-2001 Insurance
Files in this Data Supplement:
- Supplemental data: Appendix 1 - PDF file, 1 page, 55 KB
- Supplemental data: Table 1 - PDF file, 2 pages, 122 KB
The Article in Brief
The US Medical Liability System: Evidence for Legislative Reform
Janelle M. Guirguis-Blake, MD, and colleagues
Background It is widely believed that increases in malpractice insurance premiums, high awards in malpractice cases, and doctors' fear of lawsuits have contributed to rising US health care costs. This study analyzes all payments made to settle malpractice claims or satisfy malpractice judgments on behalf of doctors in the United States from 1999 through 2001.
What This Study Found There are wide variations among states in malpractice payments. Total payments for the 3-year period ranged from $15.4 million in Wyoming to more than $1.8 billion in New York. Caps on total payments and on payments for noneconomic damages are associated with lower payments. Total caps on payments are also associated with lower insurance premiums.
Implications
- The wide state-to-state variations in malpractice payments suggest that compensation for injured patients is unequal.
- Significant reductions in malpractice payments could be achieved if caps on total malpractice payments or caps on noneconomic damages are in effect nationally in the United States. Hard caps on noneconomic damages and total damages might contribute to lower insurance premiums. If tied to a comprehensive plan for reform, these reductions could be used to benefit patients, employers, physicians, and hospitals.
- The authors suggest that a broader solution to the inequities in the current liability system requires strategies aimed at improving the quality and safety of the health care system.
