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Malpractice Litigation and Nursing Home Quality of Care
Author(s) -
Konetzka R. Tamara,
Park Jeongyoung,
Ellis Robert,
Abbo Elmer
Publication year - 2013
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.12072
Subject(s) - malpractice , staffing , medicine , tort reform , certification , quality (philosophy) , tort , nursing , medical malpractice , business , liability , law , accounting , political science , philosophy , epistemology
Objective To assess the potential deterrent effect of nursing home litigation threat on nursing home quality. Data Sources/Study Setting We use a panel dataset of litigation claims and N ursing H ome O nline S urvey C ertification and R eporting ( OSCAR ) data from 1995 to 2005 in six states: F lorida, I llinois, W isconsin, N ew J ersey, M issouri, and D elaware, for a total of 2,245 facilities. Claims data are from W estlaw's A dverse F ilings database, a proprietary legal database, on all malpractice, negligence, and personal injury/wrongful death claims filed against nursing facilities. Study Design A lagged 2‐year moving average of the county‐level number of malpractice claims is used to represent the threat of litigation. We use facility fixed‐effects models to examine the relationship between the threat of litigation and nursing home quality. Principal Findings We find significant increases in registered nurse‐to‐total staffing ratios in response to rising malpractice threat, and a reduction in pressure sores among highly staffed facilities. However, the magnitude of the deterrence effect is small. Conclusions Deterrence in response to the threat of malpractice litigation is unlikely to lead to widespread improvements in nursing home quality. This should be weighed against other benefits and costs of litigation to assess the net benefit of tort reform.