Date of Award

January 2021

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Saral Mehra

Abstract

AN ANALYSIS OF OTOLARYNGOLOGY MEDICAL MALPRACTICE PAYMENTS FROM THE NATIONAL PRACTITIONER DATA BANKChristopher T. Breen and Saral Mehra. Section of Otolaryngology, Department of Surgery, Yale University, School of Medicine, New Haven, CT.

The aims of this thesis were to describe malpractice payments made on behalf of otolaryngologists, analyze trends over time, and test the association of payment amount with severity of alleged malpractice and patient age. Through a retrospective cross-sectional study of the National Practitioner Data Bank (NPDB), we analyzed all payments made on behalf of otolaryngologists from 1991 to 2018 that were reported to the NPDB. Descriptive statistics were calculated within and across years. Trends in payments were analyzed using the Mann-Kendall test. Generalized linear regression was utilized to test for association of payment amount with severity of the alleged injury and patient age. Our results showed that from 1991 to 2018 there was a significant decrease in number of payments (272 to 81) and number of otolaryngologists on whose behalf payments were made (250 to 77). Mean and median payments increased significantly from $248,848 to $420,386 and from $96,813 to $275,000, respectively. By severity of alleged injury, mean payments ranged from $39,755 (95% CI: $20,957 to $75,412) for insignificant injury to $754,349 (95% CI: $624,847 to $910,692) for patients who were left quadriplegic, sustained brain damage, or required lifelong care. By patient age, mean payments for patients 60 and older were $191,465 (95% CI: $159,880 to $229,292) vs. $247,878 (95% CI: $209,416 to $293,402) for patients 20-39 and $232,225 (95% CI: $197,691 to $272,793) for patients 40-59. In conclusion, the annual number and total value of malpractice payments decreased, while the annual mean and median payments increased. Payment amount was associated with severity of alleged malpractice and patient age.

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This is an Open Access Thesis.

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