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Vol. 17. Núm. 6.
Páginas 494-503 (noviembre - diciembre 2003)
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Vol. 17. Núm. 6.
Páginas 494-503 (noviembre - diciembre 2003)
Open Access
Responsabilidad por una práctica médica inadecuada: una perspectiva económica
Liability for medical malpractice: an economic approach
Visitas
5578
M. Carles
Autor para correspondencia
mcl@fcee.urv.es

Correspondencia: Departamento de Economía. Facultad de Ciencias Económicas y Empresariales. Universidad Rovira i Virgili. Avda. Universidad, 1. Reus. Tarragona. España.
Departamento de Economía. Facultad de Ciencias Económicas y Empresariales. Universidad Rovira i Virgili. Reus. Tarragona. España
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Información del artículo
Resumen

Los cambios en la organización de las instituciones sanitarias y el incremento del número de denuncias por mala praxis de los últimos años han puesto de relieve la necesidad de estudiar el concepto de responsabilidad médica y su repercusión en la provisión de asistencia sanitaria. Hasta el momento, el debate se ha centrado básicamente en los aspectos legales. Sin embargo, falta discutir sus implicaciones económicas.

Este trabajo revisa las investigaciones que han realizado un análisis económico del tema. En primer lugar, examinamos las que introducen paulatinamente los conceptos de incertidumbre, aversión al riesgo o riesgo moral. Posteriormente, en el entorno sanitario, prestamos especial atención a los modelos que incluyen nuevos argumentos en la función objetivo de los profesionales o, cuando existe información asimétrica, a los que plantean un problema de negociación. Por último, consideramos el mercado de seguros de responsabilidad sanitaria, y en este apartado vemos cómo la variable reputación, o la posibilidad de ejercer una medicina defensiva, influyen en la provisión de asistencia sanitaria.

Nuestro análisis sugiere que, debido a las características del mercado sanitario, deben utilizarse los modelos propuestos por la economía de la información en el análisis económico formal, pero conviene plantear hipótesis alternativas para adaptar dichos modelos a la especificidad de los distintos sistemas sanitarios.

Palabras clave:
Normas de responsabilidad
Mala praxis médica
Seguro de responsabilidad sanitaria
Abstract

In recent years, changes in the organization of healthcare institutions and the increased number of medical malpractice claims have revealed the need to study the concept of medical responsibility and the repercussion of these changes on healthcare provision. To date, discussion has focussed on legal aspects and economic implications have been largely ignored.

The present article reviews studies that have performed an economic analysis the subject. Firstly, we examine studies that gradually introduce the concepts of uncertainty, risk aversion and moral hazard. Secondly, in the healthcare environment, we pay particular attention to models that include new arguments on professionals' objective duties or to bargaining models when there is asymmetric information. Finally, we consider the medical malpractice insurance market and investigate how reputation and the possibilities of exercising defensive medicine influence healthcare provision.

Our analysis suggests that, due to the characteristics of the healthcare market, the models proposed by the economy of information are very useful for performing economic analyses of liability in medical malpractice. However, alternative hypotheses also need to be formulated so that these models can be adapted to the specific characteristics of different health systems.

Key words:
Rules of liability
Medical malpractice
Medical malpractice insurance
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Copyright © 2003. Sociedad Española de Salud Pública y Administración Sanitaria
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