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Does Admitting Mistakes to Patients Lead to More Lawsuits? FREE

[+] Article, Author, and Disclosure Information

The summary below is from the full report titled “Liability Claims and Costs Before and After Implementation of a Medical Error Disclosure Program.” It is in the 17 August 2010 issue of Annals of Internal Medicine (volume 153, pages 213-221). The authors are A. Kachalia, S.R. Kaufman, R. Boothman, S. Anderson, K. Welch, S. Saint, and M.A.M. Rogers.

Ann Intern Med. 2010;153(4):I-28. doi:10.7326/0003-4819-153-4-201008170-00001
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What is the problem and what is known about it so far?

Mistakes are common in medicine. Traditionally, physicians and hospitals have been reluctant to admit mistakes out of embarrassment or because of fear that they might be sued for malpractice. Recently, however, physicians have recognized that mistakes are an opportunity to improve the safety and quality of health care. Since 2001, the University of Michigan Health System (UMHS) has encouraged all its health care workers to report mistakes they may have made or observed. The UMHS also has a policy of telling patients and families that mistakes were made, who made them, and how they were made. If an internal inquiry suggests that a physician was at fault for an injury caused by a mistake, the system offers the patient or family financial compensation. The policy promotes honesty and quality, but it could be expensive for UMHS if more patients, family members, and attorneys seek large awards for disclosed mistakes as a result.

Why did the researchers do this particular study?

To assess how legal claims and costs changed after implementation of a policy to disclose mistakes to patients and offer compensation when UMHS is at fault.

Who was studied?

The researchers did not study people. Instead, they measured the number of legal claims and costs to UMHS.

How was the study done?

The researchers counted the number of new claims for compensation, the number of claims compensated, the time to claim resolution, and costs to the university related to those claims. They compared the measures before and after implementation of the program.

What did the researchers find?

All the study's measures (number of new claims for compensation, number of claims compensated, time to claim resolution, and costs to the university related to those claims) decreased in the period after program implementation compared with the period before.

What were the limitations of the study?

Claims were decreasing in Michigan more generally in the latter part of the study, so it is impossible to say what specific effect the UMHS program had on the changes. The UMHS physicians are employees whose malpractice insurance is covered by the university. The findings might not apply to physicians in private practice or who are otherwise self-employed and purchase their own malpractice insurance.

What are the implications of the study?

Legal claims and costs decreased during a period when a major medical center in the United States told patients when it made mistakes and offered to compensate them for injuries. The findings suggest that such a program does not necessarily open hospitals or health systems up to more lawsuits and higher legal costs.





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