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Medical Interventions among Pregnant Women in Fee-for-Service and Managed Care Insurance: A Propensity Score Analysis

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Author Info

  • Turcotte, Leo

    ()
    (West Chester University)

  • Robst, John

    ()
    (University of South Florida)

  • Polachek, Solomon

    ()
    (Binghamton University, New York)

Abstract

We extend prior research on the effect of managed care on the receipt of four medical interventions for pregnant women: ultrasound, induction/stimulation of birth, electronic fetal monitor, and cesarean delivery. Propensity score methods are used to account for sample selection issues regarding insurance choice. Managed care enrollees are more likely to receive an ultrasound, which may be indicative of receiving better prenatal care. Managed care plans reduce the rate of cesarean deliveries, but such limitations may be beneficial given the substantial medical evidence that cesarean deliveries are over utilized. The results indicate that insurance coverage does influence treatment intensity, but that utilization controls and provider financial incentives do not adversely affect care for pregnant women.

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Bibliographic Info

Paper provided by Institute for the Study of Labor (IZA) in its series IZA Discussion Papers with number 1803.

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Length: 35 pages
Date of creation: Oct 2005
Date of revision:
Publication status: published in: Applied Economics, 2006, 38 (13), 1513-1525
Handle: RePEc:iza:izadps:dp1803

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Keywords: procedure utilization; health insurance; managed care;

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  1. De Jaegher, Kris & Jegers, Marc, 2000. "A model of physician behaviour with demand inducement," Journal of Health Economics, Elsevier, vol. 19(2), pages 231-258, March.
  2. Gruber, Jonathan & McKnight, Robin, 2003. "Why did employee health insurance contributions rise?," Journal of Health Economics, Elsevier, vol. 22(6), pages 1085-1104, November.
  3. Guido W. Imbens, 1999. "The Role of the Propensity Score in Estimating Dose-Response Functions," NBER Technical Working Papers 0237, National Bureau of Economic Research, Inc.
  4. McClellan, Mark & Cutler, David & Newhous, Joseph P., 2000. "How Does Managed Care Do It?," Scholarly Articles 2643884, Harvard University Department of Economics.
  5. Currie, Janet & Gruber, Jonathan, 2001. "Public health insurance and medical treatment: the equalizing impact of the Medicaid expansions," Journal of Public Economics, Elsevier, vol. 82(1), pages 63-89, October.
  6. Elias Mossialos & Joan Costa-Font & Konstantina Davaki & Konstantinos Karras, 2005. "Is there 'patient selection' in the demand for private maternity care in Greece?," Applied Economics Letters, Taylor & Francis Journals, vol. 12(1), pages 7-12.
  7. Roland Maude-Griffin & Roger Feldman & Douglas Wholey, 2004. "Nash bargaining model of HMO premiums," Applied Economics, Taylor & Francis Journals, vol. 36(12), pages 1329-1336.
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