IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v101y2014icp47-51.html
   My bibliography  Save this article

The failure of financial incentive? The seemingly inexorable rise of cesarean section

Author

Listed:
  • Chen, Chin-Shyan
  • Liu, Tsai-Ching
  • Chen, Bradley
  • Lin, Chung-Liang

Abstract

Two policy interventions in Taiwan aiming to slow the growth of cesarean delivery utilization were respectively implemented in 2005 and 2006. The first policy provided financial incentives to encourage vaginal delivery by setting a global fee for obstetric services and in essence increasing the reimbursement for vaginal delivery up to the same level of cesarean section. The second policy aimed to reduce the demand for elective cesarean procedure by employing a copayment when cesarean section is not medically indicated. This paper examines the impact of financial incentives of both the supply and the demand side on the use of utilization of cesarean section using data from the 2003–2008 National Health Insurance Research Database. We found that while the overall trend of cesarean utilization did not seem to respond to the interventions, the policies did have significant impact on its elective use. Financial incentives for the providers do matter, and policy interventions, such as a fee change, are still important strategies to consider in reducing the over-utilization of cesarean section.

Suggested Citation

  • Chen, Chin-Shyan & Liu, Tsai-Ching & Chen, Bradley & Lin, Chung-Liang, 2014. "The failure of financial incentive? The seemingly inexorable rise of cesarean section," Social Science & Medicine, Elsevier, vol. 101(C), pages 47-51.
    • Handle: RePEc:eee:socmed:v:101:y:2014:i:c:p:47-51
    DOI: 10.1016/j.socscimed.2013.11.010
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953613005972
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2013.11.010?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    2. Lobel, Marci & DeLuca, Robyn Stein, 2007. "Psychosocial sequelae of cesarean delivery: Review and analysis of their causes and implications," Social Science & Medicine, Elsevier, vol. 64(11), pages 2272-2284, June.
    3. Chen, Chin-Shyan & Liu, Tsai-Ching & Chen, Li-Mei, 2003. "National Health Insurance and the antenatal care use: a case in Taiwan," Health Policy, Elsevier, vol. 64(1), pages 99-112, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Berta, P.; & Martini, G.; & Piacenza, M.; & Turati, G.;, 2019. "The strange case of appropriate C-sections:DRG-tariff regulation, hospital ownership, and market concentration," Health, Econometrics and Data Group (HEDG) Working Papers 19/02, HEDG, c/o Department of Economics, University of York.
    2. El-Shal, Amira & Cubi-Molla, Patricia & Jofre-Bonet, Mireia, 2021. "Are user fees in health care always evil? Evidence from family planning, maternal, and child health services," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 506-529.
    3. Bhatia, M. & Dwivedi, L.K. & Banerjee, K. & Dixit, P., 2020. "An epidemic of avoidable caesarean deliveries in the private sector in India: Is physician-induced demand at play?," Social Science & Medicine, Elsevier, vol. 265(C).
    4. Yushan Yu & Xiangyang Zhang & Caixia Sun & Huijie Zhou & Qi Zhang & Chun Chen, 2017. "Reducing the rate of cesarean delivery on maternal request through institutional and policy interventions in Wenzhou, China," PLOS ONE, Public Library of Science, vol. 12(11), pages 1-12, November.
    5. Paolo Berta & Gianmaria Martini & Massimiliano Piacenza & Gilberto Turati, 2020. "The strange case of less C‐sections: Hospital ownership, market concentration, and DRG‐tariff regulation," Health Economics, John Wiley & Sons, Ltd., vol. 29(S1), pages 30-46, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Grant, Darren, 2022. "The “Quiet Revolution” and the cesarean section in the United States," Economics & Human Biology, Elsevier, vol. 47(C).
    2. Annika Karlström & Regina Engström‐Olofsson & Astrid Nystedt & Mats Sjöling & Ingegerd Hildingsson, 2010. "Women’s postoperative experiences before and after the introduction of spinal opioids in anaesthesia for caesarean section," Journal of Clinical Nursing, John Wiley & Sons, vol. 19(9‐10), pages 1326-1334, May.
    3. Graham Cookson & Ioannis Laliotis, 2018. "Promoting normal birth and reducing caesarean section rates: An evaluation of the Rapid Improvement Programme," Health Economics, John Wiley & Sons, Ltd., vol. 27(4), pages 675-689, April.
    4. Alex Proshin & Alexandre Cazenave-Lacroutz & Lise Rochaix, 2023. "Impact of tariff refinement on the choice between scheduled C‐section and normal delivery: Evidence from France," Post-Print hal-04157204, HAL.
    5. Kim, Seung Ju & Han, Kyu-Tae & Kim, Sun Jung & Park, Eun-Cheol & Park, Hye Ki, 2016. "Impact of a diagnosis-related group payment system on cesarean section in Korea," Health Policy, Elsevier, vol. 120(6), pages 596-603.
    6. repec:zbw:rwirep:0470 is not listed on IDEAS
    7. Véra Zabrodina & Mark Dusheiko & Karine Moschetti, 2020. "A moneymaking scan: Dual reimbursement systems and supplier‐induced demand for diagnostic imaging," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1566-1585, December.
    8. Maura Francese & Massimiliano Piacenza & Marzia Romanelli & Gilberto Turati, 2011. "Understanding Inappropriateness in Health Care: The Role of Supply Structure, Pricing Policies and Political Institutions in Caesarean Deliveries," ERSA conference papers ersa11p1439, European Regional Science Association.
    9. Aleksandr Proshin & Alexandre Cazenave-Lacroutz & Zeynep Or & Lise Rochaix, 2018. "Impact of Diagnosis Related Group Refinement on the Choice Between Scheduled Caesarean Section and Normal Delivery: Recent Evidence from France," PSE Working Papers halshs-01812107, HAL.
    10. Jensen, Vibeke Myrup & Wüst, Miriam, 2015. "Can Caesarean section improve child and maternal health? The case of breech babies," Journal of Health Economics, Elsevier, vol. 39(C), pages 289-302.
    11. Sofia Amaral-Garcia & Paola Bertoli & Veronica Grembi, 2015. "Does Experience Rating Improve Obstetric Practices? Evidence From Geographical Discontinuities in Italy," CEIS Research Paper 342, Tor Vergata University, CEIS, revised 08 May 2015.
    12. Janet Currie & W. Bentley MacLeod, 2017. "Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians," Journal of Labor Economics, University of Chicago Press, vol. 35(1), pages 1-43.
    13. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    14. Chen, Chin-Shyan & Liu, Tsai-Ching & Lin, Herng-Ching & Tian, Wei-Hua, 2007. "The effect of Taiwan's National Health Insurance on infants' preventive care use and inpatient care use," Health Policy, Elsevier, vol. 80(3), pages 432-443, March.
    15. Abe Dunn & Adam Hale Shapiro, 2018. "Physician Competition and the Provision of Care: Evidence from Heart Attacks," American Journal of Health Economics, MIT Press, vol. 4(2), pages 226-261, Spring.
    16. Carine Milcent & Saad Zbiri, 2018. "Prenatal care and socioeconomic status: effect on cesarean delivery," Health Economics Review, Springer, vol. 8(1), pages 1-21, December.
    17. Bertoli, Paola & Grembi, Veronica, 2019. "Malpractice risk and medical treatment selection," Journal of Public Economics, Elsevier, vol. 174(C), pages 22-35.
    18. Liu, Tsai-Ching & Chen, Bradley & Chan, Yun-Shan & Chen, Chin-Shyan, 2015. "Does prenatal care benefit maternal health? A study of post-partum maternal care use," Health Policy, Elsevier, vol. 119(10), pages 1382-1389.
    19. Halla, Martin & Mayr, Harald & Pruckner, Gerald J. & García-Gómez, Pilar, 2020. "Cutting fertility? Effects of cesarean deliveries on subsequent fertility and maternal labor supply," Journal of Health Economics, Elsevier, vol. 72(C).
    20. Martin Chalkley, 2012. "Contracts, Information and Incentives in Health Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 22, Edward Elgar Publishing.
    21. Wen-Yi Chen, 2013. "Do caesarean section rates ‘catch-up’? Evidence from 14 European countries," Health Care Management Science, Springer, vol. 16(4), pages 328-340, December.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:101:y:2014:i:c:p:47-51. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.