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Returns to Childbirth Technologies: Evidence from Preterm Births

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Author Info

  • Daysal, N. Meltem

    ()
    (University of Southern Denmark)

  • Trandafir, Mircea

    ()
    (University of Southern Denmark)

  • van Ewijk, Reyn

    ()
    (University of Mainz)

Abstract

We investigate the impact of obstetrician supervision, as opposed to midwife supervision, on the short-term health of low-risk newborns. We exploit a unique policy rule in the Netherlands that creates a large discontinuity in the probability of a low-risk birth being attended by an obstetrician at gestational week 37. Using a fuzzy regression discontinuity design, we consistently find no health benefits from obstetrician supervision, despite increased rates of neonatal intensive care unit admissions among births supervised by obstetricians. These results indicate potential cost savings from increased use of midwifery care for low-risk deliveries.

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Bibliographic Info

Paper provided by Institute for the Study of Labor (IZA) in its series IZA Discussion Papers with number 7834.

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Length: 64 pages
Date of creation: Dec 2013
Date of revision:
Handle: RePEc:iza:izadps:dp7834

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Keywords: medical technology; birth; midwife; mortality;

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References

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  1. Douglas Almond & Joseph J. Doyle, 2011. "After Midnight: A Regression Discontinuity Design in Length of Postpartum Hospital Stays," American Economic Journal: Economic Policy, American Economic Association, American Economic Association, vol. 3(3), pages 1-34, August.
  2. Miller Amalia R, 2006. "The Impact of Midwifery-Promoting Public Policies on Medical Interventions and Health Outcomes," The B.E. Journal of Economic Analysis & Policy, De Gruyter, vol. 6(1), pages 1-36, October.
  3. Daysal, N. Meltem & Trandafir, M. & Ewijk, R. van, 2012. "Saving Lives at Birth: The Impact of Home Births on Infant Outcomes," Discussion Paper, Tilburg University, Center for Economic Research 2012-077, Tilburg University, Center for Economic Research.
  4. David S. Lee & Thomas Lemieux, 2009. "Regression Discontinuity Designs In Economics," Working Papers, Princeton University, Department of Economics, Industrial Relations Section. 1118, Princeton University, Department of Economics, Industrial Relations Section..
  5. Janet Currie & W. Bentley MacLeod, 2006. "First Do No Harm?: Tort Reform and Birth Outcomes," NBER Working Papers 12478, National Bureau of Economic Research, Inc.
  6. Guido Imbens & Thomas Lemieux, 2007. "Regression Discontinuity Designs: A Guide to Practice," NBER Technical Working Papers 0337, National Bureau of Economic Research, Inc.
  7. Bharadwaj, Prashant & Loken, Katrine Vellesen & Neilson, Christopher, 2012. "Early Life Health Interventions and Academic Achievement," IZA Discussion Papers 6864, Institute for the Study of Labor (IZA).
  8. McClellan, Mark & Noguchi, Haruko, 1998. "Technological Change in Heart-Disease Treatment: Does High Tech Mean Low Value?," American Economic Review, American Economic Association, American Economic Association, vol. 88(2), pages 90-96, May.
  9. Douglas Almond & Joseph J. Doyle, Jr. & Amanda E. Kowalski & Heidi Williams, 2008. "Estimating Marginal Returns to Medical Care: Evidence from At-Risk Newborns," NBER Working Papers 14522, National Bureau of Economic Research, Inc.
  10. Alan I. Barreca & Jason M. Lindo & Glen R. Waddell, 2011. "Heaping-Induced Bias in Regression-Discontinuity Designs," NBER Working Papers 17408, National Bureau of Economic Research, Inc.
  11. Amitabh Chandra & Jonathan Skinner, 2012. "Technology Growth and Expenditure Growth in Health Care," Journal of Economic Literature, American Economic Association, vol. 50(3), pages 645-80, September.
  12. Joseph P. Newhouse, 1992. "Medical Care Costs: How Much Welfare Loss?," Journal of Economic Perspectives, American Economic Association, American Economic Association, vol. 6(3), pages 3-21, Summer.
  13. McCrary, Justin, 2008. "Manipulation of the running variable in the regression discontinuity design: A density test," Journal of Econometrics, Elsevier, Elsevier, vol. 142(2), pages 698-714, February.
  14. David M. Cutler & Mark McClellan & Joseph P. Newhouse & Dahlia Remler, 1998. "Are Medical Prices Declining? Evidence From Heart Attack Treatments," The Quarterly Journal of Economics, MIT Press, MIT Press, vol. 113(4), pages 991-1024, November.
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Cited by:
  1. Daysal, N. Meltem & Trandafir, M. & Ewijk, R. van, 2012. "Saving Lives at Birth: The Impact of Home Births on Infant Outcomes," Discussion Paper, Tilburg University, Center for Economic Research 2012-077, Tilburg University, Center for Economic Research.

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