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Development of a composite measure of state-level malpractice environment
Jeanette W Chung1, Min-Woong Sohn, Ryan P Merkow
1Division of Surgical Oncology and the Surgical Outcomes and Quality Improvement Center, Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.
Objective:
To develop a composite measure of state-level malpractice environment.
Data Sources:
Public use data from the National Practitioner Data Bank, Medical Liability Monitor, the National Conference of State Legislatures, and the American Bar Association.
Study Design:
Principal component analysis of state-level indicators (paid claims rate, malpractice premiums, lawyers per capita, average award size, and malpractice laws), with indirect validation of the composite using receiver-operating characteristic curves to determine how accurately the composite could identify states with high-tort activity and costs.
Principal Findings:
A single composite accounted for over 73 percent of total variance in the seven indicators and demonstrated reasonable criterion validity.
Conclusion:
An empirical composite measure of state-level malpractice risk may offer advantages over single indicators in measuring overall risk and may facilitate cross-state comparisons of malpractice environments.
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