Aggressive malpractice environment ups hospital LOS

(HealthDay)—An aggressive malpractice environment is associated with increased hospitalization charges and length of stay for patients undergoing spine surgery, according to a study published in the July 1 issue of The Spine Journal.

Symeon Missios, M.D., from Louisiana State University in Shreveport, and Kimon Bekelis, M.D., from the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., examined the correlation of malpractice liability with unfavorable outcomes in spine surgery. Data were included for 707,951 patients undergoing spine surgery who were registered in the Nationwide Inpatient Sample database from 2005 to 2010. Measures of volume and size of malpractice claim payments were created using data from the National Practitioner Data Bank.

In multivariable regression analysis, the researchers observed a correlation for higher number of claims per 100 physicians in a state with increased hospitalization charges and length of stay. No correlation was seen for mortality (odds ratio, 0.99; 95 percent confidence interval, 0.87 to 1.12). Larger magnitude of awarded claims correlated with increased hospitalization charges and length of stay, but there was no correlation with mortality (odds ratio, 0.95; 95 percent confidence interval, 0.82 to 1.11).

"Aggressive malpractice environment was not correlated with mortality but was associated with higher hospitalization charges after spine surgery," the authors write. "Further research is needed to identify ways to regulate the malpractice system to address these disparities."

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