Jaz-Michael King
May 25th, 2007, 01:11 PM
Pioneering Ideas Blog
“Avoidability” as a Basis for Compensation Decisions
previous post (http://rwjfblogs.typepad.com/pioneer/2007/05/making_health_c.html)
Harvard’s Mello and Studdert continue:
Our interest in health courts grew out of a growing body evidence pointing to a number of serious disadvantages with the negligence standard: doctors tend to disagree often about whether care meets the standard; many patients suffer injuries that are avoidable but do not qualify for compensation under negligence; and a negligence judgment is perceived as highly stigmatizing.
These effects limit the potential for the tort system to send strong signals about how health care providers should be practicing, limit the potential for injured patients to get compensated, discourage openness about medical errors, and foster adversarialism and distrust between physicians and patients. We knew that several foreign systems of administrative compensation for medical injury use compensation standards other than negligence, and we were interested in finding out how workable these alternative standards were.
To explore this, we conducted sites visits in 2005 to the medical injury compensation schemes in Sweden, Denmark and New Zealand. Our aim was to understand why they chose the compensation standard they had, and how they went about making operational decisions based on it.
In the Nordic countries, the primary basis for compensation has long been “avoidability.” Patients are eligible for compensation if they experience injuries that could have been avoided under optimal circumstances.
New Zealand has recently expanded its compensation standard to cover all “treatment injuries”—injuries that are causally related to medical management, but not those that are a necessary part of treatment (e.g. the incision in a needed surgical procedure) or ordinary consequences of treatment (e.g. hair loss from chemotherapy).
Based on our interview study, we concluded that although the treatment injury standard was attractive because of its simplicity, there probably would be little political tolerance in the U.S. for the costs that would be associated with compensating all medical injuries regardless of whether they could have been prevented. Therefore, we ultimately selected the avoidability standard for the version of the health courts model we are developing. We’ll describe its feasibility more in our next post. (http://rwjfblogs.typepad.com/pioneer/2007/05/avoidability_wo.html)
Full Article @ Pioneering Ideas... (http://feeds.feedburner.com/~r/typepad/rwjfblogs/pioneer/~3/115055109/avoidability_as.html)
“Avoidability” as a Basis for Compensation Decisions
previous post (http://rwjfblogs.typepad.com/pioneer/2007/05/making_health_c.html)
Harvard’s Mello and Studdert continue:
Our interest in health courts grew out of a growing body evidence pointing to a number of serious disadvantages with the negligence standard: doctors tend to disagree often about whether care meets the standard; many patients suffer injuries that are avoidable but do not qualify for compensation under negligence; and a negligence judgment is perceived as highly stigmatizing.
These effects limit the potential for the tort system to send strong signals about how health care providers should be practicing, limit the potential for injured patients to get compensated, discourage openness about medical errors, and foster adversarialism and distrust between physicians and patients. We knew that several foreign systems of administrative compensation for medical injury use compensation standards other than negligence, and we were interested in finding out how workable these alternative standards were.
To explore this, we conducted sites visits in 2005 to the medical injury compensation schemes in Sweden, Denmark and New Zealand. Our aim was to understand why they chose the compensation standard they had, and how they went about making operational decisions based on it.
In the Nordic countries, the primary basis for compensation has long been “avoidability.” Patients are eligible for compensation if they experience injuries that could have been avoided under optimal circumstances.
New Zealand has recently expanded its compensation standard to cover all “treatment injuries”—injuries that are causally related to medical management, but not those that are a necessary part of treatment (e.g. the incision in a needed surgical procedure) or ordinary consequences of treatment (e.g. hair loss from chemotherapy).
Based on our interview study, we concluded that although the treatment injury standard was attractive because of its simplicity, there probably would be little political tolerance in the U.S. for the costs that would be associated with compensating all medical injuries regardless of whether they could have been prevented. Therefore, we ultimately selected the avoidability standard for the version of the health courts model we are developing. We’ll describe its feasibility more in our next post. (http://rwjfblogs.typepad.com/pioneer/2007/05/avoidability_wo.html)
Full Article @ Pioneering Ideas... (http://feeds.feedburner.com/~r/typepad/rwjfblogs/pioneer/~3/115055109/avoidability_as.html)