Research Activities, March 2014
Primary care malpractice cases are more difficult to defend
Often ignored in the past, focus on patient safety and malpractice risk on outpatient care is gaining attention. In fact, malpractice insurers now report the frequency and dollar amounts of settled outpatient malpractice claims exceed those of inpatient claims. AHRQ recently awarded the Commonwealth of Massachusetts money to fund the Proactive Reduction of Outpatient Malpractice-Improving Safety, Efficiency, and Satisfaction (PROMISES) Project. The goal is to identify practice and system issues in malpractice cases that can improve patient safety and interventions.
During a 5-year review period from 2005 to 2009, researchers reviewed 7,224 malpractice claims from 2 malpractice insurance carriers. A total of 7.7 percent came from primary care practices. The majority were related to diagnosis (72.1 percent), followed by 12.3 percent involving medications, and 7.4 percent involving other medical treatment. The primary diagnoses involved in these malpractice suits were cancer, heart disease, blood vessel disease, infections, and stroke. The researchers found that 35.2 percent of ambulatory cases were more likely to be settled compared to 20.5 percent of non-general medical malpractice claims. These cases were also more likely to result in a verdict for the plaintiff than non-general medical practice claims (1.6 percent vs. 0.9 percent).
According to the researchers, malpractice cases remain a burden for primary care physicians, particularly when it comes to failure to diagnose various cancers. Interventions are needed to target primary care practices to alert them to vulnerabilities and the potential for malpractice claims. The study was supported by AHRQ (T32 HS19508).
See "Primary care closed claims experience of Massachusetts malpractice insurers," by Gordon D. Schiff, M.D., Ann Louise Puopolo, R.N., B.S.N., Anne Huben-Hearney, R.N., B.S.N., M.P.A., and others in the September 30, 2013, JAMA Internal Medicine E1-E6.