Assessing legislative potential to institute error transparency: a state comparison of malpractice claims rates

The prevalence of medical errors and malpractice claims has been attributed to deficits in error reporting and disclosure. Increasingly, states are adopting error reporting and apology laws to reduce these information gaps thereby instituting error-transparent medical cultures. At the same time, doubts have been expressed about the capacity for legislation to influence medical professionals. In order to assess legislative potential to establish error transparency, a cross-sectional research design compared differences in malpractice claim rates among states adopting different legislative approaches. Two one-way analysis of variance tests were performed. The first analysis indicated that there are no significant mean differences in claims rates between states enacting only an apology law, only an error reporting law, both laws, and neither law, F (3,47)=1.13, p=.34. The second analysis indicated that there are no significant mean differences in claims rates between states enacting both laws, either law, and neither law, F (2,48)=1.08, p=.35. The findings show that legislation does not have a significant capacity to regulate malpractice claims rates. This suggests that laws governing error transparency are too remote from the delivery of healthcare services to regulate disclosure behavior and that fundamental changes in our medical culture should be initiated at an organizational level.