Trends in U.S. malpractice claims significantly change from 1992 to 2014

In 1986, Congress created the National Practitioner Data Bank (NPDB) for malpractice claims paid on behalf of U.S. physicians. Although the NPDB helped make the claims more accessible, a group of researchers in Boston thought there was still a lack of information on claims for specific specialties.

Recently, they conducted a study published in JAMA Internal Medicine that sought to more thoroughly examine malpractice clams. They found some interesting results.

Between 1992 and 2014, the rate of malpractice claims paid on behalf of U.S. physicians declined 55.7 percent, including 13.5 percent in cardiology. The rate decreased for each of the 24 specialties examined.

During that same time period, the mean compensation payment increased 23.3 percent from $286,751 to $353,473. The rate increased for all specialties. For cardiology, the mean compensation payment increased 9.1 percent from $337,605 to $368,350.

The researchers could not determine why the rate of claims paid on behalf of U.S. physicians declined, but they speculated that damage caps, statutes of limitations and other tort reforms could explain some of the change. Other possible explanations include patient safety improvements and the increasing number of communication and resolution programs. They also noted that federal law only requires written claims paid on behalf of physicians be reported to the NPDB, so claims settled on behalf of institutions are not required to be reported.

The researchers also did not know why the mean payment increased during the study, but they hypothesized that attorneys might be less willing to take cases with smaller potential payments. They also mentioned that some medical liability reforms increase the administrative burden and costs of bringing a claim. In addition, they noted that smaller claims could be settled earlier and not included in the database.

Although the data could help inform providers, patients and others about trends in malpractice claims, the researchers suggested further studies are needed.

“There were wide differences in rates of paid claims and characteristics of the alleged injuries across specialties,” they wrote. “A better understanding of the causes of variation among specialties in paid malpractice claims may help reduce patient injury and physicians’ risk of liability.”