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—Dr Saitz raises the possibility that the type of hospital to which poor patients are admitted may act as an effect modifier in the relationship between patient income or payer and malpractice suits. He hypothesizes that the poor may be more likely to sue when cared for in a private hospital setting, although less likely to sue for malpractice in public hospitals. Even after controlling for hospital ownership, we found that poor patients (odds ratio, 0.22; 95% confidence interval, 0.05 to 0.89) and uninsured patients (odds ratio, 0.05; 95% confidence interval, 0.003 to 0.73) were still significantly less likely to file malpractice claims. Therefore, the risk of malpractice claims among the poor and uninsured remains disproportionately low, regardless of hospital type.Dr Kern's study on breast cancer litigation also confirms that the poor and uninsured are less likely to sue. It is particularly poignant that Kern's data are
Burstin HR, Brennan TA. Do the Poor Sue More?-Reply. JAMA. 1994;271(7):504. doi:10.1001/jama.1994.03510310033029