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Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the US

Author

Listed:
  • Fischer, Stefanie

    (Monash University)

  • Royer, Heather

    (University of California, Santa Barbara)

  • White, Corey

    (Monash University)

Abstract

Over the last few decades, health care services in the United States have become more geographically centralized. We study how the loss of hospital-based obstetric units in over 400 counties affect maternal and infant health via a difference-in-differences design. We find that closures lead mothers to experience a significant change in birth procedures such as inductions and C-sections. In contrast to concerns voiced in the public discourse, the effects on a range of maternal and infant health outcomes are negligible or slightly beneficial. While women travel farther to receive care, closures induce women to receive higher quality care.

Suggested Citation

  • Fischer, Stefanie & Royer, Heather & White, Corey, 2023. "Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the US," IZA Discussion Papers 15987, Institute of Labor Economics (IZA).
    • Handle: RePEc:iza:izadps:dp15987
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    Cited by:

    1. Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2022. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," NBER Working Papers 30663, National Bureau of Economic Research, Inc.
    2. Dingel, Jonathan & Gottlieb, Joshua & Lozinski, Maya & Mourot, Pauline, 2023. "Market Size and Trade in Medical Services," CEPR Discussion Papers 18029, C.E.P.R. Discussion Papers.
    3. David Molitor & Corey D. White, 2023. "Do Cities Mitigate or Exacerbate Environmental Damages to Health?," NBER Working Papers 31990, National Bureau of Economic Research, Inc.
    4. Petek, Nathan, 2022. "The marginal benefit of hospitals: Evidence from the effect of entry and exit on utilization and mortality rates," Journal of Health Economics, Elsevier, vol. 86(C).
    5. Pinka Chatterji & Chun-Yu Ho & Xue Wu, 2023. "Obstetric Unit Closures and Racial/Ethnic Disparity in Health," NBER Working Papers 30986, National Bureau of Economic Research, Inc.

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    More about this item

    Keywords

    obstetric; closure; infant health; maternal health; maternity ward; hospital quality;
    All these keywords.

    JEL classification:

    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J08 - Labor and Demographic Economics - - General - - - Labor Economics Policies
    • J18 - Labor and Demographic Economics - - Demographic Economics - - - Public Policy
    • I38 - Health, Education, and Welfare - - Welfare, Well-Being, and Poverty - - - Government Programs; Provision and Effects of Welfare Programs

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