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Increased Perception of Malpractice Liability and the Practice of Defensive Medicine

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  • Brian K. Chen
  • Chun‐Yuh Yang

Abstract

The extent and existence of defensive medicine in the face of malpractice pressure are subjects of perennial policy and academic debate. In this article, we investigate the impact of a series of arguably exogenous court rulings in Taiwan that increased physicians' perceived liability exposure, and a subsequent amendment to the law that reversed the courts' rulings, on physicians' test‐ordering behavior and choice of delivery method. We find that obstetricians most at risk for liability increased laboratory tests in response to the ruling, but did not change the likelihood of delivery by Cesarean sections. We further show no consistent patterns of preventable complications, postdelivery emergency department visits, or hospital readmissions associated with physician behavioral change. The overall pattern of results is highly suggestive of the practice of defensive medicine among physicians in Taiwan, and that payment incentives and provider organizational forms may have mediated the impact of changing liability risks.

Suggested Citation

  • Brian K. Chen & Chun‐Yuh Yang, 2014. "Increased Perception of Malpractice Liability and the Practice of Defensive Medicine," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 11(3), pages 446-476, September.
  • Handle: RePEc:wly:empleg:v:11:y:2014:i:3:p:446-476
    DOI: 10.1111/jels.12046
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    References listed on IDEAS

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    1. Ronen Avraham & Leemore S. Dafny & Max M. Schanzenbach, 2009. "The Impact of Tort Reform on Employer-Sponsored Health Insurance Premiums," NBER Working Papers 15371, National Bureau of Economic Research, Inc.
    2. Toshiaki Iizuka, 2013. "Does Higher Malpractice Pressure Deter Medical Errors?," Journal of Law and Economics, University of Chicago Press, vol. 56(1), pages 161-188.
    3. Janet Currie & W. Bentley MacLeod, 2008. "First Do No Harm? Tort Reform and Birth Outcomes," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 123(2), pages 795-830.
    4. Kessler, Daniel P. & McClellan, Mark B., 2002. "How liability law affects medical productivity," Journal of Health Economics, Elsevier, vol. 21(6), pages 931-955, November.
    5. Sloan, Frank A. & Entman, Stephen S. & Reilly, Bridget A. & Glass, Cheryl A. & Hickson, Gerald B. & Zhang, Harold H., 1997. "Tort liability and obstetricians' care levels," International Review of Law and Economics, Elsevier, vol. 17(2), pages 245-260, June.
    6. Daniel P. Kessler, 2011. "Evaluating the Medical Malpractice System and Options for Reform," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 93-110, Spring.
    7. Michael Frakes, 2012. "Defensive Medicine and Obstetric Practices," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 9(3), pages 457-481, September.
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    Cited by:

    1. Scott Barkowski, 2017. "Does Regulation of Physicians Reduce Health Care Spending?," Southern Economic Journal, John Wiley & Sons, vol. 83(4), pages 1074-1097, April.
    2. Javier Cano-Urbina & Daniel Montanera, 2017. "Do tort reforms impact the incidence of birth by cesarean section? A reassessment," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 103-112, March.

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