To err on humans is not benign - Incentives for adoption of medical error-reporting systems

Concerns about frequent and harmful medical errors have led policy makers to advocate the creation of a system for medical error reporting. Health providers, fearing that reported information about errors would be used against them under the current medical malpractice system, have been reluctant to participate in such reporting systems. We propose a re-design of the malpractice system - one in which penalties are a function of the health provider's reporting efforts - to overcome this incentive problem. We also consider some alternatives to this mechanism that address two important ways in which reporting effort may not be observable: hospitals may have interests distinct from individual physicians and may not be able to observe their reporting efforts, and a regulatory agency or a court may not be able to adequately observe reporting efforts by a provider. (C) 2004 Elsevier B.V. All rights reserved.