Frequency of medical malpractice claims: the effects of volumes and specialties

A medical malpractice occurs when a physician or healthcare personnel, because of lack of skill or negligence, causes injury to a patient, who can decide to claim for the damages suffered by suing the facility and/or healthcare personnel. In this paper we analyze the frequency of medical malpractice insurance claims in an Italian region, in order to estimate the presence of significant trends and to identify volume effects at both department and healthcare organization levels. We rely on a unique dataset reporting the universe of 2144 injuries caused by medical or surgical errors that resulted in a request to the insurer for coverage over the years 2004e2010 in ten public healthcare organizations. Results show the presence of positive volume effects, as the number of malpractice claims grows less than proportionally with respect to department volumes. Volume effects are particularly relevant for orthopedics and general surgery. We also find the presence of significant positive volume effects at the level of healthcare organizations. Finally, the joint observation of the results on the frequency of malpractice claims and on the time lag between the occurrence of the malpractice event and the filing of the related claim, suggests that the number of malpractice claims has increased over time. Results indicate that organizational and managerial actions concerning the increase in volumes of specific departments or health organizations are context specific and must be specifically tailored.