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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
Leo Turcotte () (West Chester University)
John Robst () (University of South Florida)
Solomon Polachek () (State University of New York at Binghamton and IZA Bonn)

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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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Publisher 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:
Handle: RePEc:iza:izadps:dp1803

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Postal: IZA, P.O. Box 7240, D-53072 Bonn, Germany
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Related research
Keywords: health insurance; managed care; procedure utilization;

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Find related papers by JEL classification:
I10 - Health, Education, and Welfare - - Health - - - General

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References listed on IDEAS
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  1. 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. [Downloadable!] (restricted)
  2. 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. [Downloadable!] (restricted)
  3. Gruber, Jonathan & McKnight, Robin, 2003. "Why did employee health insurance contributions rise?," Journal of Health Economics, Elsevier, vol. 22(6), pages 1085-1104, November. [Downloadable!] (restricted)
  4. 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 and Francis Journals, vol. 12(1), pages 7-12, January. [Downloadable!] (restricted)
  5. David M. Cutler & Mark McClellan & Joseph P. Newhouse, 2000. "How Does Managed Care Do It?," RAND Journal of Economics, The RAND Corporation, vol. 31(3), pages 526-548, Autumn.
  6. Roland Maude-Griffin & Roger Feldman & Douglas Wholey, 2004. "Nash bargaining model of HMO premiums," Applied Economics, Taylor and Francis Journals, vol. 36(12), pages 1329-1336, July. [Downloadable!] (restricted)
  7. Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring. [Downloadable!] (restricted)
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  8. Jonathan Gruber & Robin McKnight, 2002. "Why Did Employee Health Insurance Contributions Rise?," NBER Working Papers 8878, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
  9. Ahern, Melissa, et al, 1996. "Predictors of HMO Efficiency," Applied Economics, Taylor and Francis Journals, vol. 28(11), pages 1381-90, November. [Downloadable!] (restricted)
  10. 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. [Downloadable!] (restricted)
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