While cumulative spending on malpractice payments against anesthesiologists has decreased in recent years, there has been an increase in the number of claims occurring in outpatient settings, which is consistent with the increase in outpatient anesthesia services. According to a new study, which included data from the National Practitioner Data Bank, spending on malpractice payments against anesthesiologists has fallen from $174.4 million in 2005 to $91.1 million in 2013. With increased outpatient utilization, the number of claims for outpatients has increased in comparison to claims for inpatients. However, as the amounts being paid for outpatient claims are smaller, the overall medical malpractice claims have decreased since 2005.
Presented at the 2015 annual meeting of the American Society of Anesthesiologists, the study examined the change in anesthesia related outpatient malpractice payments. Using data like patient demographics, payment size and clinical outcome to compare inpatient and outpatient malpractice claims, the researchers included 2,408 anesthesiology related malpractice payments attributed to physician providers. However, despite the shift towards outpatient services, little is known about the effect of practice setting on malpractice payments in anesthesiology.
According to the findings of the study, out of the 2,408 payments made, 1,841 (76.5%) were for inpatient claims while 567 (23.5%) were for outpatient events. However, the study found that the frequency of anesthesia related payments decreased over the 9 year study period, with inpatient payments decreasing by 45.5% and outpatient payments decreasing by 24.3%. Average malpractice payments for anesthesiology related claims was $245,000, however, payments towards inpatient claims were larger ($21,742) as compared to outpatient claim payments ($189,349).
While the study indicated that malpractice payments for inpatients were larger, the percentage of outpatient payments was more out of the total spending. This is due to the increase in outpatient surgery in the last few years. The largest claims were for death of the patient in both inpatient and outpatient settings. However, outpatient claims involved more of minor injuries to the patient. The majority of claims were from female patients and the average age was between 40 and 59 years. The study concluded that with the overall spending on malpractice payments reducing by $83.3 million, it meant that anesthetists were on the right track in their practice.
The moderator of the session, however, suggested that the increase in outpatient payments could be attributed to more than just an increase in the number of outpatient procedures. He stated that an increase in the complexity of outpatient procedures could be pushing up the malpractice payments. The researchers admitted that one of the drawbacks of the data collected was the lack of detail regarding the claims. While death was the largest reason, the second largest number of claims was for improper management – which generally includes a large number of malpractice issues.
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