Greatest percentage of catastrophic payouts occur from errors in diagnosis

A study published in the Journal for Healthcare Quality reports that many huge malpractice awards can be prevented by targeted interventions by health care provider organizations to reduce patient safety risks, such as reducing diagnosis errors. The Journal of Healthcare Quality is the peer-reviewed publication of the National Association for Healthcare Quality (NAHQ, www.nahq.org).

Despite the impact and influence of large malpractice payouts on health care costs, little is known about their specific characteristics and overall cost burden. Researchers at Johns Hopkins Medical Center, Baltimore, reviewed all U.S. pain malpractice claims from 2004 to 2010 to identify key risk factors for catastrophic payouts, defined as claims of more than $1million. They represent 8 percent of all paid malpractice claims.

Results showed that the greatest percentage of catastrophic payouts occur from errors in diagnosis. The authors noted that errors in diagnosis have twice the odds for a catastrophic payout and that health systems should focus more attention on ensuring diagnostic accuracy.

"Factors associated with catastrophic malpractice payouts present opportunities for targeted risk management and quality improvement efforts, " said co-author Martin A. Makary, M.D, MPH, a surgeon and professor at Johns Hopkins.

The authors concluded that future studies should evaluate targeted interventions to improve patient safety in areas associated with catastrophic malpractice payouts, including efforts to improve diagnostic accuracy.