The effects of malpractice tort laws on physicians' practice behaviors surrounding cesarean deliveries

Increasing health care costs due to the change in physicians' practice behaviors toward more costly treatment procedures have been of great concern to patients, the health care community, policy makers and third party payers. An increase in the number of cesarean deliveries has been the focus of attention on changing physicians' practice behaviors since the late 1960s. Although the rate of cesarean deliveries has stabilized in recent years, it is still the most common surgical procedure in the United States. A changing medical malpractice environment, including an increasing number of claims filed against physicians, the increasing indemnities paid for claims, and increasing liability premiums for physicians, are considered important factors in changing physicians' practice behaviors.;This study examines the impact of the malpractice environment on physicians' practice behaviors surrounding cesarean deliveries. Medical malpractice tort laws and the changing liability premiums of physicians are proxies used to measure the impact of medical malpractice environment on physicians' practice behaviors. The primary hypothesis is that tort law changes have led to fewer cesarean deliveries by providing physicians with a more secure and friendly malpractice environment and by encouraging them to practice less costly delivery procedures.;The main source of data is the Colorado Hospital Inpatient Discharge Data. Colorado is chosen for the study because of the availability of data and the number of tort laws enacted during the study period. Colorado Hospital Inpatient Discharge Data may suffer from the problem that physicians may indicate risky medical and clinical conditions of patients to justify the cesarean deliveries. Therefore this study explores ways of correcting for this problem.;The results of the study indicate that physicians perform fewer cesarean deliveries during the period of 1987 through 1992 when compared to the period before 1987. This is also the time period when major tort law reforms are enacted or amended. The results indicate that non-medical factors also significantly affect physicians' practice behaviors surrounding cesarean deliveries.