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How Does Routine Disclosure of Medical Error Affect Patients' Propensity to Sue and Their Assessment of Provider Quality?

Evidence From Survey Data

Helmchen, Lorens A., PhD*; Richards, Michael R., MD, MPH; McDonald, Timothy B., MD, JD

doi: 10.1097/MLR.0b013e3181eaf84d
Original Article

Background: Although strongly favored by patients and ethically imperative for providers, the disclosure of medical errors to patients remains rare because providers fear that it will trigger lawsuits and jeopardize their reputation. To date little is known how patients might respond to their providers' disclosure of a medical error even when paired with an offer of remediation.

Research Design: A representative sample of Illinois residents was surveyed in 2008 about their knowledge about medical errors, their confidence that their providers would disclose medical errors to them, and their propensity to sue and recommend providers that disclose medical errors and offer to remedy them. We report the response patterns to these questions. As robustness checks, we also estimate the covariate-adjusted distributions and test the associations among these dimensions of medical-error disclosure.

Results: Of the 1018 respondents, 27% would sue and 38% would recommend the hospital after medical error disclosure with an accompanying offer of remediation. Compared with the least confident respondents, those who were more confident in their providers' commitment to disclose were not likely to sue but significantly and substantially more likely to recommend their provider.

Conclusions: Patients who are confident in their providers' commitment to disclose medical errors are not more litigious and far more forgiving than patients who have no faith in their providers' commitment to disclose.

From the *School of Public Health, Division of Health Policy and Administration and Institute of Government and Public Affairs, University of Illinois, Chicago, IL; †College of Medicine and School of Public Health, Division of Health Policy and Administration, University of Illinois, Chicago, IL; and ‡College of Medicine, Departments of Pediatrics and Anesthesiology, University of Illinois Medical Center, Departments of Anesthesiology and Safety & Risk Management, University of Illinois, Chicago, IL.

Supported by funding from NIA grant T32 AG000186–21 (to L.A.H.).

Reprints: Lorens A. Helmchen, PhD, National Bureau of Economic Research, 1050 Massachusetts Ave, Room 418 Cambridge, MA 02138. E-mail:

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© 2010 Lippincott Williams & Wilkins, Inc.