Use of the Physician Insurers Association of America Database as a Surveillance Tool for Diabetes-Related Malpractice Claims in the U.S.

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Abstract
OBJECTIVE To examine the available national surveillance data on malpractice claims associated with diabetes and to determine the medical specialties having the highest number of claims and the classes and costs of filed claims relating to diabetes. RESEARCH DESIGN AND METHODS Data was abstracted from the Data Sharing Reports (DSRs) of the Physicians Insurers Association of America (PIAA), as well as a search of the PIAA's computerized database for the period spanning 1 January 1985 to 31 December 1996. Data on numbers of claims, medical causes of loss, indemnity paid, demographics of claimants and physicians, severity, and medical specialties with diabetes-related claims were available. RESULTS A total of 906 diabetes claims were reported to PIAA, and the total indemnity paid was $26,892,848. A significant downward trend (P = 0.004) was noted for the period between 1993 and 1996. Diabetes claimants were older and predominately male, relative to all claimants. Ophthalmology, internal medicine, and general and family practice had the highest rates of reported claims at 16.5, 13.6, and 13.4 diabetes claims per 1,000 claims, respectively. Of the diabetes-related injuries, 44% occurred in the practitioner's office, as compared with 27% for all claims. A greater proportion of diabetes claims were associated with the highest level of severity of injury with respect to all claims compiled by the PIAA. CONCLUSIONS The database of the PIAA can be a useful resource to monitor trends in diabetes-related malpractice. Further study into whether claims result from lack of adherence to practice guidelines is needed. Prevention programs designed to reduce the liability among high-risk specialties may also lead to improved care for the patient with diabetes.