Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Malpractice, defensive medicine, and obstetric behavior

A D Tussing1, M A Wojtowycz

  • 1Department of Economics, Maxwell Graduate School of Citizenship and Public Affairs, Syracuse University, NY 13244, USA. tussing@syr.edu

Medical Care
|February 1, 1997
PubMed
Summary

Physician fear of malpractice in obstetrics drives defensive medicine, increasing cesarean section rates. This defensive practice, influenced by diagnostic tools and fetal distress diagnoses, is costly.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Organisational variation, satisfaction, and women's time investment in prenatal care.

Paediatric and perinatal epidemiology·1999
Same author

Early language development in children exposed to or infected with human immunodeficiency virus.

Pediatrics·1998
Same author

Physical activity, obesity, and diabetes in pregnancy.

American journal of epidemiology·1997
Same author

Biopsy findings in five hundred thirty-one patients with atypical glandular cells of uncertain significance as defined by the Bethesda system.

American journal of obstetrics and gynecology·1997
Same author

Papanicolaou smears by the Bethesda system in endometrial malignancy: utility and prognostic importance.

Obstetrics and gynecology·1997
Same author

Unintended pregnancy and breast-feeding behavior.

American journal of public health·1997

Area of Science:

  • Obstetrics and Gynecology
  • Health Economics
  • Medical Malpractice Law

Background:

  • Defensive medicine is a concern in obstetrics, potentially increasing healthcare costs.
  • Understanding the impact of malpractice fear on clinical decisions is crucial for evaluating obstetric care quality.

Purpose of the Study:

  • To investigate the presence and extent of defensive medicine in obstetric practice.
  • To quantify the influence of malpractice fear on diagnostic procedures and delivery methods.

Main Methods:

  • Analysis of 58,441 obstetric deliveries in New York State using merged vital statistics and hospital discharge records.
  • Proxying physician malpractice fear by cumulative obstetric malpractice suits by county (1975-1986).
  • Application of a generalized probit analysis to assess relationships between variables.

Related Experiment Videos

Main Results:

  • Malpractice exposure slightly influences the use of electronic fetal monitors (EFM).
  • Fear of malpractice impacts the diagnosis of fetal distress, both directly and via EFM use.
  • Fear of malpractice directly and indirectly increases cesarean section (c-section) rates, accounting for an estimated 6.6 percentage points of the overall 27.6% c-section rate.

Conclusions:

  • The study provides evidence supporting the existence of defensive medicine in obstetrics.
  • While the desirability of defensive medicine is unclear, it incurs significant costs.
  • Malpractice fear influences obstetric decision-making, leading to increased interventions and costs.