Non-elective cesarean sections in public hospitals: hospital capacity constraints and doctor´s incentives
AbstractUsing administrative records of births from the Perinatal Surveillance System of the Social Security System (ESSALUD) in Peru, we test whether high admissions of pregnant women affected unplanned cesarean section rates in the ESSALUD public hospitals during the period 2005-2006. To this purpose, we present a basic theoretical model that considers not only physician preference for leisure but also the effect of hospital capacity constraints. Based on inferences of this model, we find that physician demand for leisure increases the probability of a c-section in the smallest hospitals, while hospital constraints set a limit on the number of cesarean sections that can be performed. We discuss the policy implications of our findings and the policies implemented in ESSALUD to monitor the quality of obstetric services and avoid unnecessary or unjustified c-sections.
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Bibliographic InfoPaper provided by Departamento de Economía - Universidad Pública de Navarra in its series Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra with number 1212.
Date of creation: 2012
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- Sarkis, Joseph, 2000. "A comparative analysis of DEA as a discrete alternative multiple criteria decision tool," European Journal of Operational Research, Elsevier, vol. 123(3), pages 543-557, June.
- Evans, William N. & Kim, Beomsoo, 2006. "Patient outcomes when hospitals experience a surge in admissions," Journal of Health Economics, Elsevier, vol. 25(2), pages 365-388, March.
- Brown, H. III, 1996. "Physician demand for leisure: implications for cesarean section rates," Journal of Health Economics, Elsevier, vol. 15(2), pages 233-242, April.
- Ching-to Albert Ma, 1994.
"Health Care Payment Systems: Cost and Quality Incentives,"
0047, Boston University - Industry Studies Programme.
- Ma, Ching-to Albert, 1994. "Health Care Payment Systems: Cost and Quality Incentives," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 3(1), pages 93-112, Spring.
- Andrew Epstein & Sean Nicholson, 2005.
"The Formation And Evolution Of Physician Treatment Styles: An Application To Cesarean Sections,"
- Epstein, Andrew J. & Nicholson, Sean, 2009. "The formation and evolution of physician treatment styles: An application to cesarean sections," Journal of Health Economics, Elsevier, vol. 28(6), pages 1126-1140, December.
- Andrew Epstein & Sean Nicholson, 2005. "The Formation and Evolution of Physician Treatment Styles: An Application to Cesarean Sections," NBER Working Papers 11549, National Bureau of Economic Research, Inc.
- Alejandro Arrieta & Ariadna García Prado & Jorge Guillén, 2009.
"The Private Health Care Sector and the Provision of Prenatal Care Services in Latin America,"
9335, Inter-American Development Bank.
- Arrieta, Alejandro & García-Prado, Ariadna & Guillén, Jorge, 2011. "The Private Health Care Sector and the Provision of Prenatal Care Services in Latin America," World Development, Elsevier, vol. 39(4), pages 579-587, April.
- Patricia Triunfo & Máximo Rossi, 2009. "The effect of physicians’ remuneration system on the Caesarean section rate: the Uruguayan case," International Journal of Health Care Finance and Economics, Springer, vol. 9(4), pages 333-345, December.
- Litvak, Nelly & van Rijsbergen, Marleen & Boucherie, Richard J. & van Houdenhoven, Mark, 2008. "Managing the overflow of intensive care patients," European Journal of Operational Research, Elsevier, vol. 185(3), pages 998-1010, March.
- Rajiv Sharma & Miron Stano & Renu Gehring, 2008. "Short-term fluctuations in hospital demand: implications for admission, discharge, and discriminatory behavior," RAND Journal of Economics, RAND Corporation, vol. 39(2), pages 586-606.
- Daniele Fabbri & Chiara Monfardini, 2006.
"Style of practice and assortative mating: a recursive probit analysis of cesarean section scheduling in Italy,"
CHILD Working Papers
wp06_06, CHILD - Centre for Household, Income, Labour and Demographic economics - ITALY.
- Daniele Fabbri & Chiara Monfardini, 2008. "Style of practice and assortative mating: a recursive probit analysis of Caesarean section scheduling in Italy," Applied Economics, Taylor & Francis Journals, vol. 40(11), pages 1411-1423.
- D. Fabbri & C. Monfardini, 2006. "Style of practice and assortative mating: a recursive probit analysis of cesarean section scheduling in Italy," Working Papers 557, Dipartimento Scienze Economiche, Universita' di Bologna.
- J Hurley & R Labelle, 1994.
"Relative Fees and the Utilization of Physicians' Services in Canada,"
Centre for Health Economics and Policy Analysis Working Paper Series
1994-06, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
- Jeremiah Hurley & Roberta Labelle, 1995. "Relative fees and the utilization of physicians' services in Canada," Health Economics, John Wiley & Sons, Ltd., vol. 4(6), pages 419-438, November.
- Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
- Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August.
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