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Does Tort Law Improve the Health of Newborns, or Miscarry? A Longitudinal Analysis of the Effect of Liability Pressure on Birth Outcomes

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  • Y. Tony Yang
  • David M. Studdert
  • S. V. Subramanian
  • Michelle M. Mello

Abstract

Previous research has identified an association between malpractice liability risk levels in a state and greater use of cesarean sections in obstetrical care. However, it is unclear whether such practice changes are associated with better birth outcomes. Using a mixed‐effects model, we investigate the impact of malpractice risk, as measured by malpractice insurance premiums and various state tort reforms, on four adverse birth outcomes. We use a longitudinal research design to examine millions of individual births from 51 jurisdictions over 12 years (1991–2002). We find that the odds of adverse birth outcomes are not associated with premium levels or tort reforms. Our results suggest that rather than having a socially desirable deterrent effect on substandard care, liability pressure may produce a level of precaution taking in obstetrics that is higher than socially optimal. By the same token, the results also suggest that the adoption of liability‐limiting reforms is unlikely to have an adverse impact on outcomes.

Suggested Citation

  • Y. Tony Yang & David M. Studdert & S. V. Subramanian & Michelle M. Mello, 2012. "Does Tort Law Improve the Health of Newborns, or Miscarry? A Longitudinal Analysis of the Effect of Liability Pressure on Birth Outcomes," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 9(2), pages 217-245, June.
    • Handle: RePEc:wly:empleg:v:9:y:2012:i:2:p:217-245
    DOI: 10.1111/j.1740-1461.2012.01252.x
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    References listed on IDEAS

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    1. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
    2. Michelle M. Mello & David M. Studdert & Eric J. Thomas & Catherine S. Yoon & Troyen A. Brennan, 2007. "Who Pays for Medical Errors? An Analysis of Adverse Event Costs, the Medical Liability System, and Incentives for Patient Safety Improvement," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 4(4), pages 835-860, December.
    3. Kotelchuck, M., 1994. "An evaluation of the Kessner Adequacy of Prenatal Care Index and a proposed Adequacy of Prenatal Care Utilization Index," American Journal of Public Health, American Public Health Association, vol. 84(9), pages 1414-1420.
    4. Kachalia, Allen B. & Mello, Michelle M. & Brennan, Troyen A. & Studdert, David M., 2008. "Beyond negligence: Avoidability and medical injury compensation," Social Science & Medicine, Elsevier, vol. 66(2), pages 387-402, January.
    5. 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.
    6. Conway, Karen Smith & Deb, Partha, 2005. "Is prenatal care really ineffective? Or, is the 'devil' in the distribution?," Journal of Health Economics, Elsevier, vol. 24(3), pages 489-513, May.
    7. Y. Tony Yang & David M. Studdert & S. V. Subramanian & Michelle M. Mello, 2008. "A Longitudinal Analysis of the Impact of Liability Pressure on the Supply of Obstetrician‐Gynecologists," Journal of Empirical Legal Studies, John Wiley & Sons, vol. 5(1), pages 21-53, March.
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    Cited by:

    1. Paola Bertoli & Veronica Grembi, 2018. "Medical Malpractice: How Legal Liability Affects Medical Decisions," Contributions to Economic Analysis, in: Health Econometrics, volume 127, pages 235-261, Emerald Group Publishing Limited.
    2. Zabinski, Zenon & Black, Bernard S., 2022. "The deterrent effect of tort law: Evidence from medical malpractice reform," Journal of Health Economics, Elsevier, vol. 84(C).
    3. Morita, Hatsuru, 2018. "Criminal prosecution and physician supply," International Review of Law and Economics, Elsevier, vol. 55(C), pages 1-11.
    4. Malak, Natalie & Yang, Y. Tony, 2019. "A re-examination of the effects of tort reforms on obstetrical procedures and health outcomes," Economics Letters, Elsevier, vol. 184(C).

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