The county paid $8 million to settle those cases in 2005 and $12 million in 2007, according to the study from the Abaris Group, a Walnut Creek-based health care consulting firm.
The 60-page report was commissioned by the Board of Supervisors to review the health department's efforts to prevent medical malpractice and improve patient safety.
The authors wrote that there were still outstanding claims for 2008 and 2009, and it was not possible to include the amount of settlements in those years.
The report found the number of malpractice cases filed against county hospitals and clinics dropped from 354 in 2002 to 107 last year.
The authors noted this drop may partially relate to patient safety efforts in the health care industry in general and at the Department of Health Services.
"Overall, (the Department of Health Services) notes the advances that have been made within the department, but recognizes that there is room for improvement," Chief Executive Officer Bill Fujioka wrote in a memo to the supervisors.
The health department did not return calls for comment. The supervisors will receive a briefing on the report today.
"Essentially, we feel encouraged," said Roxane Marquez, spokeswoman for Supervisor Gloria Molina, who represents the 1st District, which includes Pomona. "The consultant seemed to feel that overall the department has done a much better job when it comes to quality assurance and risk management, and those are two things Supervisor Molina has been adamant about since the day she took office."
The authors wrote they found evidence that the health agency is making progress in responding more quickly to patient safety problems, but the day-to-day demands of keeping patients safe have increased, and patient safety procedures have become cumbersome.
"This has greatly impaired (the Quality Improvement and Patient Safety Unit's) ability to create a system-wide culture of safety with clear priorities that improve quality and reduce claims," the authors wrote.
In response, Abaris recommended the health department change the way it handles its corrective action plans to one that focuses on a system to reduce medical mistakes rather than one that lays blame on people after medical mistakes are made.
"Having a safety culture doesn't mean there is no role for punishment," the authors wrote. "Punishment is indicated for willful misconduct, reckless behavior and unjustified, deliberate violations of rules ... but not for human error."