Medical Malpractice in Public Healthcare Systems: An Empirical Investigation of Scheduled Damages

In the last decades, medical malpractice has been framed as one of the most critical issues for healthcare providers and health policy, holding a central role on both the policy agenda and public debate. The Law and Economics literature has devoted much attention to medical malpractice and to the investigation of the impact of malpractice reforms. Nonetheless, some reforms have been much less empirically studied as in the case of schedules, and their effects remain highly debated. The present work seeks to contribute to the study of medical malpractice and of schedules of noneconomic damages in a civil law country with a public national health system, using Italy as case study. Besides considering schedules and exploiting a quasi-experimental setting, the novelty of our contribution consists in the inclusion of the performance of the judiciary (measured as courts’ civil backlog) in the empirical analysis. The empirical analysis is twofold. First, it investigates how limiting compensations for pain and suffering through schedules impacts on the malpractice insurance market in terms of presence of private insurers and of premiums applied. Second, it examines whether, and to what extent, healthcare providers react to the implementation of this policy in terms of both levels and composition of the medical treatments offered. Our findings show that the introduction of schedules increases the presence of insurers only in inefficient courts, while it does not produce significant effects on paid premiums. Judicial inefficiency is attractive to insurers for average values of schedules penetration of the market, with an increasing positive impact of inefficiency as the territorial coverage of schedules increases. Moreover, the implementation of schedules tends to reduce the use of defensive practices on the part of clinicians, but the magnitude of this impact is ultimately determined by the actual degree of backlog of the court implementing schedules.

Advanced public transportation systems: the state of the art update '98.

Federal Transit Administration, Washington, D.C.

Advanced public transportation systems: the state of the art update '94. Final report.

Federal Transit Administration, Washington, D.C.

Evaluation guidelines for the advanced public transportation systems operational tests.

Federal Transit Administration, Washington, D.C.

Advanced public transportation systems : the state of the art : update 2000 /

"December 2000"--P. [4] of cover.

Projections and comparisons of alternative formulas for providing state aid to public library systems /

WI docs. no.: Leg.3:D/1978/9.

Statistics of local public school systems; staff.

Mode of access: Internet.

Demonstration of photovoltaic power source in remote applications : lighting, weather data gathering and public demonstration systems : Wildlife Prairie Park, Peoria, Illinois.

"Printed: May 1990."

Directory of Illinois public retirement systems and pension funds /

"December 2005."

Directory of Illinois public retirement systems and pension funds /

"August 2008"

Directory of Illinois public retirement systems and pension funds /

"March 2010."

Illinois plan for public health systems change.

A report by Public Health Futures Illinois that proposes goals and recommended actions for developing a prevention-focused, integrated system of public health service delivery in Illinois.

Illinois public retirement systems : a report on the financial condition of the Chicago, Cook County and Illinois Municipal Retirement Fund Systems.

Examines the financial status of the various public employee retirement systems in the Chicago, Cook County Area and the Illinois Municipal Retirement Fund (IMRF).

The Financial condition of the Illinois public retirement systems /

Cover title.

The MacBride principles : survey of U.S. companies in Northern Ireland and analysis of the investments of Illinois public pension systems in those companies : final report.

"October 1989."