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Evaluative reports on medical malpractice policies in obstetrics: a rapid scoping review

Authors :
Roberta Cardoso
Wasifa Zarin
Vera Nincic
Sarah Louise Barber
Ahmet Metin Gulmezoglu
Charlotte Wilson
Katherine Wilson
Heather McDonald
Meghan Kenny
Rachel Warren
Sharon E. Straus
Andrea C. Tricco
Source :
Systematic Reviews, Vol 6, Iss 1, Pp 1-11 (2017)
Publication Year :
2017
Publisher :
BMC, 2017.

Abstract

Abstract Background The clinical specialty of obstetrics is under particular scrutiny with increasing litigation costs and unnecessary tests and procedures done in attempts to prevent litigation. We aimed to identify reports evaluating or comparing the effectiveness of medical liability reforms and quality improvement strategies in improving litigation-related outcomes in obstetrics. Methods We conducted a rapid scoping review with a 6-week timeline. MEDLINE, EMBASE, LexisNexis Academic, the Legal Scholarship Network, Justis, LegalTrac, QuickLaw, and HeinOnline were searched for publications in English from 2004 until June 2015. The selection criteria for screening were established a priori and pilot-tested. We included reports comparing or evaluating the impact of obstetrics-related medical liability reforms and quality improvement strategies on cost containment and litigation settlement across all countries. All levels of screening were done by two reviewers independently, and discrepancies were resolved by a third reviewer. In addition, two reviewers independently extracted relevant data using a pre-tested form, and discrepancies were resolved by a third reviewer. The results were summarized descriptively. Results The search resulted in 2729 citations, of which 14 reports met our eligibility criteria. Several initiatives for improving the medical malpractice litigation system were found, including no-fault approaches, patient safety policy initiatives, communication and resolution, caps on compensation and attorney fees, alternative payment system and liabilities, and limitations on litigation. Conclusions Only a few litigation policies in obstetrics were evaluated or compared. Included documents showed that initiatives to reduce medical malpractice litigation could be associated with a decrease in adverse and malpractice events. However, due to heterogeneous settings (e.g., economic structure, healthcare system) and variation in the outcomes reported, the advantages and disadvantages of initiatives may vary.

Details

Language :
English
ISSN :
20464053
Volume :
6
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Systematic Reviews
Publication Type :
Academic Journal
Accession number :
edsdoj.95b44c9c0aa4973bc9f47ed2db7942b
Document Type :
article
Full Text :
https://doi.org/10.1186/s13643-017-0569-5