EFFECTS OF THE THREAT OF MEDICAL MALPRACTICE LITIGATION AND OTHER FACTORS ON BIRTH OUTCOMES

Most major health reform proposals include reform of medical malpracti ce. A major objective of the current medical malpractice system is to improve quality of care. The authors examine the effect of variations in the threat of medical malpractice, measured by claims frequency and payments per exposure year, on various indicators of birth outcomes, fetal deaths, low Apgar score, death within 5 days of birth, infant de ath, and death or permanent impairment at 5 years of age. Data came fr om 2 sources: a Survey of Obstetrical Care of 963 women in Florida in 1992 who delivered 5 years previously; and a fetal death and a linked birth-death file obtained from Florida Vital Statistics for 1987. Amon g the outcomes considered, only fetal deaths decreased in response to an increased threat of being sued, and this relationship was only obta ined from one of the data sets. Overall, no systematic improvement in birth outcomes in response to an increased threat of medical malpracti ce litigation was obtained.