The subject of this paper was medical malpractice settlement and related cases. The settlement procedures in Y medical center and its 6 subsidiary hospitals were examined. There were 205 claimed cases for the past 10 years(1989-1998). Independent
variables were doctor, patient, case circumstances, and case settlement, which were subdivided into 20 items. Malpractice cases were classified by 20 independent variables and computerized. The first stage was to analyze cost difference caused by
20
independent variables and computerized. The first stage was to analyze cost difference caused by variables by the method of SAS statistics package(t-test and ANOVA). The second stage was to understand variables which influence malpractice
cost(dependent
variable) by the method of multiple regression. Main findings are as follows. 1. The number of malpractice cases occurred in each department : Internal medicine experienced the highest number of malpractice cases, 29, followed by neurological
surgery(26), obstetrics and gynecology(23), pediatrics(16), general surgery(14), and orthopedics(14). The number of malpractice cases per each doctor(a clinical professor) or 10 years was 1.67 in thoractic surgery, 1.53 in neurological surgery,
1.44
cosmetic surgery, 1.25 in emergency medicine, 1.15 in obstetrics and gynecology. Departments which experienced higher number of malpractice cases such as internal medicine, pediatrics, general surgery showed 0.57, 0.59, 0.54 cases per a doctor
respectively, which were close to average number of 0.54. On the contrary departments which experienced lower number of malpractice cases such as thoractic surgery, cosmetic surgery, emergency medicine showed 1.67, 1.44, 1.25 cases per a doctor
respectively. 2. The proportion of average expenditure per a case to expenditure per a doctor: In neurological surgery(expenditure per a case to expenditure per a doctor was 69,500,000 to 106,290,000), thoractic surgery(42,920,000 to 71,530,000)
and
cosmetic surgery(45,410,000 to 65,590,000), expenditure per a doctor was higher than expenditure per a case, which imposed financial burden on hospitals. On the other hand, in anaesthesia department(106,190,000 to 45,510,000), dental
surgery(58,880,000
to 7,070,000), psychiatry(32,780,000 to 8,200,000), and ophthalmology(28,440,000 to 4,060,000), expenditure per a doctor was relatively low, less burden for hospitals. 3. The result of uni-variate analysis : It was statistically significant that
average
malpractice cost went up when legal proceedings were filed during settlement procedures, The result of multi-variate analysis : The consequence of cases exercised decisive effect on average cost. The effect of legal proceedings could be ignored.
So
it
was not likely that patients would receive a larger amount of damages through legal proceedings in Y medical center. In this study insubstantial factors were not examined. However, in reality, those insubstantial factors which accompany legal
proceedings such as mental stress of medical staff related to malpractice, time consumed for the preparation of materials(opportunity cost), and defamation would inflict greater loss on hospitals. In respect to malpractice cost, patients will
focus
on
damages, while hospitals will focus on total cost including medical fee, administration fee(lawyer, stamp, appraisal), overhead cost(labor, education), and damages In respect to expenditure generated in each department, patients will focus on the
average cost of the department(average damages per a case), while hospital will focus on expenditure per a doctor. In other words, approach to the issue will decide the size of cost and the subject of analysis. This study is significant in that
malpractice cost was analyzed from a hospital's point of view.
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