Defensive Medicine as a Response to Medical Malpractice Liability in the United States

Grant Description: What is the extent and costs of defensive medicine across the entire spectrum of medical care provided in the United States? In this first phase of the project, the researchers built databases supporting analysis of defensive medicine costs. In anticipated follow-on analyses, the researchers will use medical and pharmaceutical claims data from CIGNA Healthcare to identify those clinical conditions in which defensive medicine exists, estimate the frequency and costs of defensive medicine in those conditions, and identify the sources of defensive medicine (e.g., type of tests, procedures, and medications) in those conditions. The researchers will also analyze the relationship between the cost of episodes of care and “tort signals,” which include medical malpractice insurance premiums and frequency of malpractice claims. The objective of this study was to develop a data set permitting more accurate estimation of defensive medicine costs.

Policy Summary: In the first of a two phase project, the researchers built a unique analytic database to support an investigation of defensive medicine costs in the United States. The database includes detailed specification of procedures performed and resources utilized during more than 35 million episodes of care, covering the entire spectrum of medical and surgical care. It also includes county-level data for nearly 1,000 counties, and an additional 9 states, on the average number of medical malpractice suits filed per year. And it includes medical malpractice insurance premiums faced by physicians of every specialty practicing in every county of 30 different states. In the second phase of the project, the researchers expect to be able to provide definitive answers to questions about the costs of services and resources associated with defensive medicine in the United States.