0201 Medical Malpractice Payments Following Mild Sleep Loss and the Daylight Saving Time Shift

Abstract

Abstract Introduction The national cost of the medical liability system exceeds $10 billion/year, but not all medical errors result in a malpractice claim or payment. Malpractice claims are more likely if the medical error is perceived as severe, if the physician is perceived as lacking empathy, and if negative emotional reactions are triggered in the patient (due to individual or contextual factors). In recent experimental work, participants who were mildly sleep restricted showed an increased propensity to want to punish physicians for medical errors and compensate patients the maximum allowed. Building upon this laboratory work, we evaluated 30 years of medical malpractice claims to determine whether the judgment of final compensation increased after the Spring daylight saving time (DST) shift. Methods We obtained medical malpractice payment data on 373,643 United States cases from the National Practitioner Data Bank (NPDB). We contrasted inflation-adjusted payments across states that have DST shifts relative to non-DST control states (e.g., Arizona, Hawaii). We compared post-Spring DST payments to payments during the two weeks before/after the DST, and averaged payments for the remainder of the year. Results The total number of claims was unrelated to Spring DST, however, the size of malpractice payments significantly increased the week following the spring DST shift relative to non-DST control states and relative to the averaged payments for the remainder of the year. Spring DST was associated with an inflation-adjusted relative increase in malpractice payments by $7,836 to $61,809 per case (depending on comparison). Malpractice payments did not change in relation to the Fall DST shift. Conclusion Mild sleep restriction alters the cognitive and emotional regulation processes that underpin perceptions of medical error severity, willingness to punish, and judgments of appropriate compensation for medical errors. Support N/A