The impact of malpractice fears on cesarean section rates

A longstanding issue in the health care industry is whether physicians' mal practice fears lead to defensive medicine. We use national birth certificat e 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 me dicine in obstetrics but that the impact of increased cesarean sections tha t results from malpractice fears on total obstetric care costs is small. Th e study also finds that physicians' defensive response varies with the soci oeconomic status of the mother. (C) 1999 Elsevier Science B.V. All rights r eserved.