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Understanding variations in medical malpractice rates within New York State.

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	Understanding variations in medical malpractice rates within New York State.
作者:	Hart, Kevin D.
面頁冊數:	201 p.
附註:	Source: Dissertation Abstracts International, Volume: 63-04, Section: A, page: 1531.
附註:	Supervisor: Dana Mukamel.
Contained By:	Dissertation Abstracts International63-04A.
標題:	Law.
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3050836
ISBN:	0493652949

Understanding variations in medical malpractice rates within New York State.
Hart, Kevin D.

Understanding variations in medical malpractice rates within New York State. [electronic resource] - 201 p.

Source: Dissertation Abstracts International, Volume: 63-04, Section: A, page: 1531.

Thesis (Ph.D.)--The University of Rochester, 2002.

<italic>Conclusions</italic>. Both medical system and legal system characteristics influence the rate of malpractice claims across counties of a state. The surprising negative association between the proportion of discharges in the highest risk group for adverse outcomes and the claims rate may indicate that variations in the quality of medical care influence the rate of claims, although more research is needed to explore this relationship. Policymakers need to consider the reasons for within state variations in malpractice claims when considering legislation to reduce malpractice claims frequency.

ISBN: 0493652949Subjects--Topical Terms:

207600
Law.

Understanding variations in medical malpractice rates within New York State.
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500 $a Source: Dissertation Abstracts International, Volume: 63-04, Section: A, page: 1531.
500 $a Supervisor: Dana Mukamel.
502 $a Thesis (Ph.D.)--The University of Rochester, 2002.
520 # $a <italic>Conclusions</italic>. Both medical system and legal system characteristics influence the rate of malpractice claims across counties of a state. The surprising negative association between the proportion of discharges in the highest risk group for adverse outcomes and the claims rate may indicate that variations in the quality of medical care influence the rate of claims, although more research is needed to explore this relationship. Policymakers need to consider the reasons for within state variations in malpractice claims when considering legislation to reduce malpractice claims frequency.
520 # $a <italic>Methods</italic>. Data to calculate claims rates for New York State counties came from a database maintained by the New York State Department of Health, to which malpractice insurance carriers must report all malpractice claims. The multivariate analysis, with the county as the unit of observation, used both weighted least squares regression and Poisson regression.
520 # $a <italic>Purpose</italic>. This research sought to explain variations in medical malpractice claims within a single state. It also sought to test the hypothesis that managed care penetration is associated with rates of claims.
520 # $a <italic>Results</italic>. County malpractice rates varied from 0 to 183 per 100,000 population. Multivariate analysis showed that higher household income, density of lawyers, and hospital discharges per capita, along with being in the Long Island area, were all associated with higher rates of malpractice claims. High proportions of hospital discharges rated the riskiest for patient injury and high proportions of successful claims in the prior three years were all associated with lower rates of malpractice. In some analyses high physician density was associated with lower claims rates as well. Despite the fact that other research found that the degree of urbanization was a significant explanatory variable for claims rates, the county's population density had no statistically significant effect on rates.
520 # $a In none of the analyses did high managed care penetration show a statistically significant association with higher claims rates. In one multivariate analysis using Poisson regression managed care penetration showed a negative and significant association with claims rates, although the model did not meet the goodness of fit tests.
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