Stochastic model estimates savings from mediation in malpractice disputes

A freely available stochastic simulation tool estimated positive financial and time savings from adopting mediation for medical malpractice claims rather than sending every eligible dispute to trial, but the results depended on the costs, durations, resolution rates and success probabilities specified by users. In a high-income scenario applying mediation to 2,000 eligible claims annually over 10 years, the model produced mean net present value savings of US$114.08 million, with a 95% simulation interval of US$81.15 million to US$149.36 million.

The same high-income scenario projected mean aggregate case-resolution time savings of 13,204 court-years, defined as the sum of case-resolution years avoided across claims. Its 95% simulation interval ranged from 9,733 to 16,661 court-years. These estimates describe the difference modeled between a mediation strategy and an all-trial comparator; they are not measured reductions in court costs, backlogs or individual case durations.

Projected savings were also positive in middle- and low-income scenarios. Mean net present value savings were US$47.77 million and US$13.64 million, respectively, while mean time savings were 15,864 and 12,611 court-years. Across all three scenarios, the financial and time results depended on the assumptions entered into the model. The published findings therefore describe scenario-based projections rather than observed outcomes from a clinical trial or a demonstrated causal effect of mediation.

Researchers developed the tool as a user-friendly R/Shiny application that uses stochastic simulation to compare a mediation strategy with an all-trial comparator. The application estimates net present value savings in money and aggregate case-resolution time savings. It allows stakeholders and policymakers to vary inputs for local costs, case durations, mediation-resolution rates and conditional-success assumptions, making it possible to examine how alternative assumptions affect the projected results.

The study presents a planning tool rather than evidence that every mediation program will generate the modeled savings. The positive estimates apply under the specified scenarios and parameters, and their relevance to a particular jurisdiction depends on the inputs used. The open-access application is intended to support exploration of mediation strategies under different assumptions, without establishing that mediation itself produced the projected reductions or that the results can be generalized beyond the modeled conditions.

Subject of Research: Stochastic cost-benefit modeling of mediation in medical malpractice disputes

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

Article References: Lioupi, O., Kostoulas, P., Griva, K., Billinis, C., & Tsiamis, C. (2026). A stochastic cost–benefit analysis tool for estimating the economic and time savings of mediation in medical malpractice disputes. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15480-4

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15480-4

Keywords: Medical malpractice, Dispute mediation, Stochastic simulation, Cost-benefit analysis, Net present value, Healthcare policy, R Shiny, Case resolution time, stochastic, cost, benefit, analysis