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The Ecology of defensive medicine and malpractice litigation

Antoci, Angelo and Fiori Maccioni, Alessandro and Russu, Paolo (2016) The Ecology of defensive medicine and malpractice litigation. PLoS One, Vol. 11 (3), e0150523. ISSN 1932-6203. Article.

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DOI: 10.1371/journal.pone.0150523


Using an evolutionary game, we show that patients and physicians can interact with predator-prey relationships. Litigious patients who seek compensation are the ‘predators’ and physicians are their ‘prey’. Physicians can adapt to the risk of being sued by performing defensive medicine. We find that improvements in clinical safety can increase the share of litigious patients and leave unchanged the share of physicians who perform defensive medicine. This paradoxical result is consistent with increasing trends in malpractice claims in spite of safety improvements, observed for example in empirical studies on anesthesiologists. Perfect cooperation with neither defensive nor litigious behaviors can be the Pareto-optimal solution when it is not a Nash equilibrium, so maximizing social welfare may require government intervention.

Item Type:Article
ID Code:11716
Uncontrolled Keywords:Defensive medicine, malpractice litigation, clinical risk, legal risk, predator-prey model, evolutionary game
Subjects:Area 13 - Scienze economiche e statistiche > SECS-S/06 Metodi matematici dell'economia e delle scienze attuariali e finanziarie
Divisions:001 Università di Sassari > 01-a Nuovi Dipartimenti dal 2012 > Scienze economiche e aziendali
Publisher:Public Library of Science
Copyright Holders:© 2016 Antoci et al.
Deposited On:25 May 2017 12:48

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