Disclosure-and-Resolution Programs that Include Generous Compensation Offers May Prompt a Complex Patient Response

Posted: 6 Dec 2012

See all articles by Lindsey Murtagh

Lindsey Murtagh

Harvard School of Public Health - Department of Health Policy and Management

Thomas H. Gallagher

University of Washington

Penny Andrew

Buddle Findlay

Michelle M. Mello

Stanford Law School; Department of Medicine

Date Written: December 3, 2012

Abstract

Under “disclosure-and-resolution” programs, health systems disclose adverse events to affected patients and their families; apologize; and, where appropriate, offer compensation. Early adopters of this approach have reported reduced liability costs, but the extent to which these results stem from effective disclosure and apology practices, versus compensation offers, is unknown. Using survey vignettes, we examined the effects of different compensation offers on individuals’ responses to disclosures of medical errors compared to explanation and apology alone. Our results show that although two-thirds of these individuals desired compensation offers, increasing the offer amount did not improve key outcomes. Full-compensation offers did not decrease the likelihood of seeking legal advice and increased the likelihood that people perceived the disclosure and apology as motivated by providers’ desire to avoid litigation. Hospitals, physicians, and malpractice insurers should consider this complex interplay as they implement similar initiatives. They may benefit from separating disclosure conversations and compensation offers and from excluding physicians from compensation discussions.

Keywords: malpractice, liability, medical error, disclosure, compensation

JEL Classification: I10, K13

Suggested Citation

Murtagh, Lindsey and Gallagher, Thomas H. and Andrew, Penny and Mello, Michelle M., Disclosure-and-Resolution Programs that Include Generous Compensation Offers May Prompt a Complex Patient Response (December 3, 2012). Health Affairs, Vol. 31, No. 12, 2012, Available at SSRN: https://ssrn.com/abstract=2185695

Lindsey Murtagh

Harvard School of Public Health - Department of Health Policy and Management ( email )

677 Huntington Avenue
Boston, MA 02115
United States

Thomas H. Gallagher

University of Washington ( email )

Seattle, WA 98195
United States

Penny Andrew

Buddle Findlay ( email )

Wellington
New Zealand

Michelle M. Mello (Contact Author)

Stanford Law School ( email )

559 Nathan Abbott Way
Stanford, CA 94305-8610
United States
650-725-3894 (Phone)

HOME PAGE: http://https://law.stanford.edu/directory/michelle-m-mello/

Department of Medicine ( email )

Center for Health Policy / PCOR
Encina Commons
Stanford, CA 94305
United States

HOME PAGE: http://https://profiles.stanford.edu/michelle-mello?tab=bio

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