Work

A stochastic cost–benefit analysis tool for estimating the economic and time savings of mediation in medical malpractice disputes

Year: 2026

Type: article

Abstract: Medical malpractice disputes can impose substantial economic and time burdens on healthcare systems and patients. Mediation has been proposed as a less adversarial alternative to litigation that is cost and time efficient. We developed a user-friendly, freely available R/Shiny application that uses stochastic simulation to project the net present value (NPV) of monetary savings and aggregate case-resolution time savings from the adoption of a mediation strategy relative to an all-trial comparator. Under the specified assumptions, projected monetary and time savings were positive in all three scenarios. In the high-income scenario, applying the mediation strategy to 2,000 eligible claims annually over 10 years produced mean NPV savings of US$114.08 million (95% simulation interval [SI] US$81.15–149.36 million) and mean time savings of 13,204 court-years (the sum of case-resolution years avoided across claims; 95% SI 9,733–16,661). Corresponding mean savings in the middle- and low-income scenarios were US$47.77 million and US$13.64 million, with 15,864 and 12,611 court-years saved, respectively. The tool allows stakeholders and policymakers to explore potential savings using locally relevant cost, duration, mediation-resolution rates, and conditional-success assumptions. Clinical trial number: Not applicable.

Source: BMC Health Services Research

DOI: 10.1186/s12913-026-15480-4

Authors: Olympia Lioupi, Polychronis Kostoulas, Konstadina Griva, Charalambos Billinis, Costas Tsiamis

Institutions: University of Thessaly, Nanyang Technological University

Language: English

Topic: Medical Malpractice and Liability Issues

Subfield: Pharmacy

Field: Health Professions

Domain: Health Sciences

SDG: Peace, justice, and strong institutions

Open Access status: gold

Estimated APC paid: $3,290