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Hospitals can forestall costly malpractice litigation by owning up to their mistakes and offering fair compensation before patients or their families even realize the error, a study suggests.

The study, published today in the Annals of Internal Medicine, looks at a policy in effect since 1987 at the Veterans Affairs Medical Center in Lexington, Ky. The policy calls for full disclosure to patients who are injured either accidentally or through medical negligence.

"This diminishes the anger and desire for revenge that often motivate patients' litigation," wrote Dr. Steve S. Kraman, hospital chief of staff. He said plaintiffs' attorneys become more willing to negotiate a settlement without trying to punish the institution with a big verdict.

The study, written by Kraman and the hospital's legal counsel, compared the 407-bed hospital's liability payments with those of 38 similar veterans hospitals from 1990 through 1996.

The center paid out $1.3 million during the period, an average of $190,113 a year, or $15,622 per claim. Liability payments at the other hospitals ranged from less than $1 million to $12 million. Only six had lower liability totals than the Lexington hospital; 28 had higher totals.

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