June 6th, 2020

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Analysis of the Trend in the Cost of Professional Liability Insurance and Obstetricians and Gynecologists Workforce in the United States from 2005 to 2015
Authors:  Edward Kim, M.D., M.P.H., William Rayburn, M.D., M.B.A., and Imam Xierali, Ph.D.
  OBJECTIVE: To review the trend in the cost of professional liability insurance (PLI) and obstetrics and gynecology (Ob/Gyn) workforce in the U.S. from 2005 to 2015.

STUDY DESIGN: We obtained the PLI cost data from Medical Liability Monitor and calculated the Ob/Gyn workforce density from the American Medical Association’s Physician Masterfile and the U.S. Census for the years 2005 to 2015.

RESULTS: Nationally, there has been an approximately 21% decrease in the cost of PLI, 10% increase in the absolute number of Ob/Gyns, and 0.62% increase in the Ob/Gyn workforce density in this period. A negative binomial regression model showed a significantly positive relationship between these 2 variables, with an incidence rate ratio (IRR) of 1.005 (p = 0.006). In other words, the Ob/Gyn workforce density increased by 0.5% with every $10,000 increase in the cost of PLI. This likely represents that there is no relationship between the cost of PLI and Ob/Gyn workforce density.

CONCLUSION: The cost of PLI does not appear to have an effect on the Ob/Gyn workforce. Thus, we remain optimistic for the future of the Ob/Gyn workforce and professional liability climate. Investigation of the effect of cost of PLI on Ob/Gyn relocation pattern is a possible future direction for research.
Keywords:  American Medical Association; costs and cost analysis; gynecology; health workforce; insurance, liability; malpractice/economics; malpractice trends; medical liability; no-fault insurance; obstetrics; practice patterns; professional liability
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