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Differences in the obstetric malpractice claims filed by Medicaid and non-Medicaid patients
1Department of Family Medicine, University of Washington, Seattle 98195.
Background:
Many physicians believe Medicaid patients are more likely than non-Medicaid patients to file malpractice claims. This study examines the accuracy of this belief in regard to obstetric malpractice claims.
Methods:
Claims filed between January 1982 and June 1988 from the major malpractice insurer in Washington State were used to compare obstetric malpractice claims filed on behalf of Medicaid and non-Medicaid patients.
Results:
Eleven percent (7/62) of all closed obstetric claims were filed by Medicaid patients, whereas 19 percent of all births in Washington State were to Medicaid patients between 1982 and 1988. Failure to diagnose or treat a fetal condition was the most commonly alleged negligence in both Medicaid and non-Medicaid groups. Most claims in both groups were settled before the cases went to court; a substantial minority of claims were dropped. The mean cost of Medicaid claims ($406,984) was three times that of non-Medicaid claims ($133,743), suggesting that paid Medicaid claims were more severe than paid non-Medicaid claims.
Conclusions:
Medicaid patients appear no more likely to file obstetric malpractice claims than non-Medicaid patients. The low likelihood of filing claims, coupled with large settlements, suggests that Medicaid patients may have less access to legal services than non-Medicaid patients.
Insights
Physicians
Area of Science:
- Medical Malpractice Law
- Health Services Research
- Obstetrics and Gynecology
Background:
- Physician perception suggests higher malpractice claim rates among Medicaid patients.
- This study investigates the validity of this perception in obstetric malpractice cases.
Purpose of the Study:
- To compare the rate of obstetric malpractice claims filed by Medicaid versus non-Medicaid patients.
- To analyze the characteristics and outcomes of these claims.
Main Methods:
- Analysis of obstetric malpractice claims data from Washington State's major insurer (1982-1988).
- Comparison of claim filing rates relative to birth rates for Medicaid and non-Medicaid populations.
Main Results:
- Medicaid patients filed claims at a rate lower than their proportion of births (11% of claims vs. 19% of births).
- Failure to diagnose fetal conditions was the most common allegation for both groups.
- Medicaid claims had a higher mean cost, indicating greater severity.
Conclusions:
- Medicaid patients are not more likely to file obstetric malpractice claims.
- Lower claim filing rates and higher settlement costs suggest potential barriers to legal access for Medicaid patients.