Sarasota, FL (WorkersCompensation.com) – A recent analysis from medical professional liability company Coverys shows that although there have been massive improvements in legislation, safety measures and workflow practices, there has not been a dramatic change in overall malpractice claims, and providers in certain demographics have more of them.
Covery reviewed data from 11,907 events resulting in 20,211 closed claims from 2010 to 2019. An event is considered an episode of care, whereas a claim refers to individual malpractice claims against a provider during that episode of care.
Medium severity injuries accounted for the largest portion of events and indemnity payments. Medium severity injuries totaled 42.4 percent of events and 31.1 percent of indemnity payments paid out. Deaths ranked second at 23.8 percent of events, and 37.5 percent of indemnity payouts. High severity injuries accounted for 8.7 percent of events and 29.3 percent of indemnity payments. When viewed at a claim level, high severity injuries and deaths accounted for 33 percent of claims and the total remained steady from year to year. Low severity injuries accounted for 25.1 percent of events and 2.1 percent of indemnity payouts.
From 2010 to 2014, the average claim rate per 100 providers was 4.6. From 2015 to 2019, the total dropped to 4.3. While obstetrics and surgery make up the large majority of claims, surgery claims have dropped.
Due to the fact that claims can sometimes take several years to settle, Covery reviewed claims data from 2006 to 2016 to analyze them by physician age group. The data showed that surgeons aged 35 to 44 had the highest claim rates overall, averaging 12.2 claims per 100 surgeons. When broken out by all types of physicians, the age category had a claims rate of 3.6 claims per 100 physicians.
Physicians of all types aged 45 to 54 ranked second in the number of claims at 3.3 claims per 100 physicians. Physicians aged 55 to 64 ranked third at 3.2 claims per 100 providers. The age category with the lowest number of claims included 65 to 75 at 2.3 claims per 100 physicians, and 25 to 34 at a rate of 2.0 claims per 100 physicians.
When broken out by specialty, General Medicine saw an increase in the number of claims with a noticeable spike in 2018. In 2010, the average claim rate per 100 physicians was 3.1. By 2019 that claim number had increased to 3.8. The average rate of claims during the 10-year span with an indemnity paid out was 23 percent with an average payout of $449,000.
Although surgery claims had a higher claim rate per 100 providers, overall the number of surgery claims decreased during the time span but the indemnity amounts paid out increased. In 2010, the claim rate for surgery was 11.5 percent and by 2019 that total decreased to 10.1 per 100 surgeons. The average indemnity paid out in 2010 was $338,050 and by 2019 that amount had increased to $383,306. The average rate of surgery claims during the 10-year span with an indemnity payout was 25 percent.
Additionally, there was a decrease in orthopedic surgery claims from 2015 to 2017. Neurosurgery accounted for the largest portion of physicians with more than one claim; however, according to the analysis the overall claims volume is dropping. Thoracic and cardiac claims saw an increase in claim volume. Thoracic in particular saw a spike in claims volume in 2017 and again in 2019.
Radiology was another specialty that showed a downward trend. In 2010 the claim rate for 100 providers was 7.8 and by 2019 the total dropped to 5.5. The number of radiology claims with an indemnity payout was 27. Interestingly enough, the analysis pointed out that radiologists over the age of 54 were less likely to be sued.
Anesthesiology claims dropped by over half during the decade. In 2010, the claim rate was 4.7 per 100 providers and by 2019 the rate had dropped to 2.3. The percent of anesthesiology with indemnity payout was 21 percent. Age appeared to be a factor in claim volume as the analysis mentioned that anesthesiologists aged 55 to 64 held the largest percentage of claims. The analysis attributes an emphasis on simulation and decision training, along with available data as factors contributing to the improvement of claims numbers.
Overall, 63 percent of surgical claims involve a physician with more than one claim. Surgery ranked first for top specialties with multiple claims at 8.7 percent for 2 claims, and 3.5 percent for 3 or more claims. Neurosurgery ranked top surgery specialty at 19.8 percent for 2 claims, and 10.4 percent for 3 or more claims. Trauma surgery ranked fourth at 12.7 percent for 2 claims, and 7.9 percent for 3 or more, followed by general surgery at 9.5 percent for 2 claims, and 3.6 percent for 3 or more claims. Orthopedic ranked sixth at 8.1 percent for 2 claims, and 3.5 percent with 3 or more claims filed.
The Covery analysis made mention of high demands and burnout as potential contributors to the malpractice data not matching the overall efforts taken for patient safety. With additional stresses not seen in the previous 10 years, experts are interested to see what the data trends are for 2020.
The full whitepaper, which includes additional breakdowns by specialty, is available on the Covery website.