Development of a Composite Measure of State-Level Malpractice Environment
Article first published online: 11 OCT 2013
© Health Research and Educational Trust
Health Services Research
Volume 49, Issue 2, pages 751–766, April 2014
How to Cite
Chung, J. W., Sohn, M.-W., Merkow, R. P., Oh, E. H., Minami, C., Black, B. S. and Bilimoria, K. Y. (2014), Development of a Composite Measure of State-Level Malpractice Environment. Health Services Research, 49: 751–766. doi: 10.1111/1475-6773.12110
- Issue published online: 27 MAR 2014
- Article first published online: 11 OCT 2013
- Manuscript Accepted: 29 JUN 2013
- Department of Surgery
- Feinberg School of Medicine
- Northwestern University
- State health policies;
- health policy;
- observational data
To develop a composite measure of state-level malpractice environment.
Public use data from the National Practitioner Data Bank, Medical Liability Monitor, the National Conference of State Legislatures, and the American Bar Association.
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.
A single composite accounted for over 73 percent of total variance in the seven indicators and demonstrated reasonable criterion validity.
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.