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Disclosure-and-resolution programs that include generous compensation offers may prompt a complex patient response.
Lindsey Murtagh1, Thomas H Gallagher, Penny Andrew
1law firm Hogan Lovells, in Washington, D.C., USA.
Health Affairs (Project Hope)
|December 6, 2012
Summary
Disclosure-and-resolution programs involve disclosing adverse events, apologizing, and offering compensation. However, increasing compensation amounts did not improve patient outcomes or reduce legal action likelihood.
Area of Science:
- Medical error disclosure
- Patient compensation strategies
- Healthcare liability reduction
Background:
- Disclosure-and-resolution programs are increasingly adopted by health systems to manage adverse events.
- These programs involve disclosure, apology, and compensation, with reported reductions in liability costs.
- The specific impact of compensation offers versus disclosure and apology alone remains unclear.
Purpose of the Study:
- To examine the effect of varying compensation offers on patient responses to medical error disclosures.
- To compare the impact of compensation against explanation and apology alone.
Main Methods:
- Utilized survey vignettes to present hypothetical medical error scenarios.
- Manipulated the amount of compensation offered in the vignettes.
- Assessed participants' responses, including likelihood of seeking legal advice and perceptions of the disclosure.
Main Results:
- Two-thirds of participants desired compensation offers.
- Increasing compensation amounts did not enhance key outcomes.
- Full compensation offers did not reduce the likelihood of seeking legal advice.
- Full compensation offers increased the perception that disclosures were litigation-driven.
Conclusions:
- Compensation amount does not appear to be the primary driver of positive outcomes in disclosure programs.
- Separating disclosure conversations from compensation offers may be beneficial.
- Excluding physicians from compensation discussions could improve patient perceptions.
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