Administrative Compensation for Medical Injuries: Lessons From Three Foreign Systems

Examines "no-fault" systems in New Zealand, Sweden, and Denmark, in which patients injured by medical negligence can file for compensation through governmental or private adjudicating organizations. Considers lessons for U.S. medical malpractice reform

Rationalizing Noneconomic Damages: A Health-Utilities Approach

Studdert et al examine why making compensation of noneconomic damages in personal-injury litigation more rational and predictable is socially valuable. Noneconomic-damages schedules as an alternative to caps are discussed, several potential approaches to construction of schedules are reviewed, and the use of a health-utilities approach as the most promising model is argued. An empirical analysis that combines health-utilities data created in a previous study with original empirical work is used to demonstrate how key steps in construction of a health-utilities-based schedule for noneconomic damages might proceed

Geographic Variation in Informed Consent Law: Two Standards for Disclosure of Treatment Risks

We analyzed 714 jury verdicts in informed consent cases tried in 25 states in 1985–2002 to determine whether the applicable standard of care (“patient” vs. “professional” standard) affected the outcome. Verdicts for plaintiffs were significantly more frequent in states with a patient standard than in states with a professional standard (27 percent vs. 17 percent, P = 0.02). This difference in outcomes did not hold for other types of medical malpractice litigation (36 percent vs. 37 percent, P = 0.8). The multivariate odds of a plaintiff’s verdict were more than twice as high in states with a patient standard than in states with a professional standard (odds ratio = 2.15, 95% confidence interval = 1.32–3.50). The law’s expectations of clinicians with respect to risk disclosure appear to vary geographically

Can the United States Afford a “No-Fault” System of Compensation for Medical Injury?

One of the key issues separating US critics of a no-fault alternative to the tort system for compensating victims of medical injury from supporters is its anticipated cost. Results from a study are presented that estimate the costs of a no-fault system, one that is similar to the system now in operation in Sweden, within the context of the US health care system

The role of governing boards in improving patient experience: Attitudes and activities of health service boards in Victoria, Australia

The authors sought to determine the attitudes of public health service board members and senior executives toward patient experience and to describe the governance activities of the boards in this area. The study was based on an online survey of 322 board members from 85 public health services and semi-structured interviews with 35 board members and senior executives from 13 public health services in Victoria, Australia. The results showed that while some health service boards had high aspirations and clear plans for improving patient experience, others remained sluggish or even cynically resistant to changing their existing models of care. Interviewees associated with highly active boards described initiatives to improve patient experience at multiple levels in the organisation - from boardroom to bedside. Among less active boards, efforts to improve patient experience tended to be more ad hoc and there was greater uncertainty about how to scale up or systematise. The authors conclude that addressing the gap between the responsibility of boards to address patient experience, and the reality of their governance activities, requires a nuanced understanding of the attitudes and activities of board members. The approaches taken by “positive attitude, high activity” boards could be showcased as exemplars for others

Strategies and Practices in Off-Label Marketing of Pharmaceuticals: A Retrospective Analysis of Whistleblower Complaints

Abstract Background: Despite regulatory restrictions, off-label marketing of pharmaceutical products has been common in the US. However, the scope of off-label marketing remains poorly characterized. We developed a typology for the strategies and practices that constitute off-label marketing

Crop residue grazing and tillage systems effects on soil physical properties and corn (Zea Mays L.) performance

Crop-livestock systems under no till (NT) could negatively affect soil physical properties and crop performance, due to the additive effects of reduced soil cover and cattle trampling due to livestock grazing, and the absence of tillage. We evaluated the effects of four grazing strategies and of a shallow tillage (ST) on soil physical properties and corn (Zea mays L.) performance for a mollisol after 15 years under crop-livestock systems under NT in Argentina. Grazing strategies evaluated were: closure (C), one grazing (OG), high stocking rate (HR) and farmer's management (FM), and the tillage systems were: NT and ST. Bulk density (BD), penetration resistance (PR), hydraulic conductivity (ks), plant population, surface root distribution, aboveground dry matter accumulation, aboveground total N (TN) accumulation and corn yield were evaluated. High stocking rate and FM increased RP. On the other hand, ST decreased PR and BD and increased ks. Corn yield was higher under ST than under NT, and under HR than under the other grazing strategies. Total N accumulation was higher under HR than under the rest of grazing strategies. Rational grazing management and use of tillage systems on resilient soils could have prevented soil physical properties be affected beyond critical thresholds.Facultad de Ciencias Agrarias y Forestale