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Tort Claims Analysis in the Veterans Health Administration for Quality Improvement

Published online by Cambridge University Press:  01 January 2021

Extract

Tort claims have been studied for various reasons. Several studies have found that most tort claims are not related to negligent adverse events and most negligent adverse events do not result in tort claims. Several studies have examined the disposition of tort claims to understand the likelihood of payment once a claim has been made. Still others have proposed that tort-claims trend analysis may help administrators target their quality-improvement efforts and identify problems with quality that would not otherwise be captured.

In this article, we conduct a tort-claims analysis to explore areas for quality improvement, specifically for patient safety, in the Veterans Health Administration (VHA). Patient safety is an increasingly highlighted aspect of health-care delivery. Failure to assure patient safety can result in bad clinical outcomes, additional costs of care, and a negative organizational image. Filing a tort claim is one way for an individual to express concern about an organization. For our analysis, we draw from resolved tort claims in the Veterans Health Administration from fiscal years 1989 to 2000.

Type
Article
Copyright
Copyright © American Society of Law, Medicine and Ethics 2001

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References

Leape, L.L. et al., “The Nature of Adverse Events in Hospitalized Patients. Results of the Harvard Medical Practice Study II,” N. Engl. J. Med., 324 (1991): 377–84; Localio, A.R. et al., “Relation Between Malpractice Claims and Adverse Events Due to Negligence. Results of the Harvard Medical Practice Study III,” N. Engl. J. Med., 325 (1991): 245-51; Farber, H. and White, M., “Medical Malpractice: An Empirical Examination of the Litigation Process,” Rand Journal of Economics, 22 (1991): 199-217; Sloan, F. et al., Suing for Medical Malpractice (Chicago: The University of Chicago Press, 1993); Brennan, T.A., Sox, C. and Burstin, H., “Relation Between Negligent Adverse Events and the Outcomes of Medical-Malpractice Litigation,” N. Engl. J. Med., 335 (1996): 1963-67; Studdert, D.M. et al., “Negligent Care and Malpractice Claiming Behavior in Utah and Colorado,” Medical Care, 38 (2000): 250-60.CrossRefGoogle Scholar
Farber, and White, supra note 1; Danzon, P., The Disposition of Medical Malpractice Claims (Santa Monica: The Rand Corporation, 1980); Danzon, P., The Frequency and Severity of Medical Malpractice Claims (Santa Monica: The Rand Corporation, 1982); White, M.J., “The Value of Liability in Medical Malpractice,” Health Affairs, 13, no. 4 (1994): 75-87; Bovbjerg, R., Medical Malpractice: Problems and Reforms (Washington, D.C.: The Urban Institute, 1995); Granville, R.L., Williamson, J. and Guay, J.D., “Characteristics of Department of Defense Medical Malpractice Claims: A Quality Management Tool,” Legal Medicine, 1999 (1999): 7-14.Google Scholar
Granville, , Williamson, and Guay, supra note 2; Kravitz, R.L., Rolph, J.E. and McGuigan, K., “Malpractice Claims Data as a Quality Improvement Tool: I. Epidemiology of Error in Four Specialties,” JAMA, 266 (1991): 2087–92; Neale, G., “Clinical Analysis of 100 Medicolegal Cases,” British Medical Journal, 307 (1993): 1483-87.Google Scholar
28 U.S.C.A. §§ 2671–2680 (West 1994 & Supp. 2001).Google Scholar
As used here, r is the correlation coefficient (using Pearson two-tailed); p is a statistical measure of significance.Google Scholar
Bovbjerg, supra note 2.Google Scholar
Danzon, , The Disposition of Medical Malpractice Claims, supra note 2.Google Scholar
Burstin, H.R. et al., “Do the Poor Sue More? A Case-Control Study of Malpractice Claims and Socioeconomic Status,” JAMA, 270 (1993): 1697–701.Google Scholar
Wilson, N.J. and Kizer, K.W., “The VA Health Care System: An Unrecognized National Safety Net,” Health Affairs, 16, no. 4 (1997): 200–04.Google Scholar
Sloan, et al., supra note 1.Google Scholar
Penchansky, R. and Macnee, C., “Initiation of Medical Malpractice Suits: A Conceptualization and Test,” Medical Care, 32 (1994): 813–31; Levinson, W. et al., “Physician-Patient Communication. The Relationship with Malpractice Claims Among Primary Care Physicians and Surgeons,” JAMA, 277 (1997): 553-59.Google Scholar
Burstin, H.R. et al., “The Effect of Hospital Financial Characteristics on Quality of Care,” JAMA, 270 (1993): 845–49.CrossRefGoogle Scholar
Weeks, W.B. et al., “Using an Improvement Model to Reduce Adverse Drug Events in VA Facilities,” Joint Commission Journal on Quality Improvement, 27 (May 2001): 243–54.Google Scholar
Weeks, W.B. and Bagian, J.P., “Developing a Culture of Safety in the Veterans Health Administration,” Effective Clinical Practice, 6 (November/December 2000): 270–76.Google Scholar
Danzon, , The Disposition of Medical Malpractice Claims, supra note 2; Bovbjerg, supra note 2.Google Scholar
Fanaeian, N. and Merwin, E., “Malpractice: Provider Risk or Consumer Protection,” American Journal of Medical Quality, 16 (2001): 4357.CrossRefGoogle Scholar
Localio, et al., supra note 1; Fanaeian, and Merwin, supra note 16; Thomas, E.J. et al., “Incidence and Types of Adverse Events and Negligent Care in Utah and Colorado,” Medical Care, 38 (2000): 261–71.Google Scholar