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Physician Financial Incentives and Cesarean Delivery: New Conclusions from the Healthcare Cost and Utilization Project

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  • Darren Grant

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    (Department of Economics and International Business, Sam Houston State University)

Abstract

This paper replicates Gruber, Kim, and Mayzlin’s (1999) analysis of the effect of physician financial incentives on cesarean delivery rates, using their data, sample selection criteria, and specification. Coincident trends explain much of their estimated positive relation between fees and cesarean utilization, which also falls somewhat upon the inclusion of several childbirth observations that had been inadvertently excluded from their estimation sample. The data ultimately indicate that a $1000 increase, in current dollars, in the reimbursement for a cesarean section increases cesarean delivery rates by about one percentage point, one-quarter of the effect estimated originally.

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File URL: http://www.shsu.edu/%7Etcq001/paper_files/wp08-01_paper.pdf
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Bibliographic Info

Paper provided by Sam Houston State University, Department of Economics and International Business in its series Working Papers with number 0801.

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Date of creation: Aug 2008
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Handle: RePEc:shs:wpaper:0801

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  1. 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.
  2. Fernández-Val, Iván, 2009. "Fixed effects estimation of structural parameters and marginal effects in panel probit models," Journal of Econometrics, Elsevier, vol. 150(1), pages 71-85, May.
  3. 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.
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Cited by:
  1. Wen-Yi Chen, 2013. "Do caesarean section rates ‘catch-up’? Evidence from 14 European countries," Health Care Management Science, Springer, vol. 16(4), pages 328-340, December.
  2. Diane Alexander, 2013. "Does Physician Compensation Impact Procedure Choice and Patient Health?," Working Papers 1475, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
  3. Maura Francese & Massimiliano Piacenza & Marzia Romanelli & Gilberto Turati, 2011. "Understanding Inappropriateness in Health Care: The Role of Supply Structure, Pricing Policies and Political Institutions in Caesarean Deliveries," ERSA conference papers ersa11p1439, European Regional Science Association.
  4. Chen, Chin-Shyan & Liu, Tsai-Ching & Chen, Bradley & Lin, Chung-Liang, 2014. "The failure of financial incentive? The seemingly inexorable rise of cesarean section," Social Science & Medicine, Elsevier, vol. 101(C), pages 47-51.
  5. Janet Currie & W. Bentley MacLeod, 2013. "Diagnosis and Unnecessary Procedure Use: Evidence from C-Section," NBER Working Papers 18977, National Bureau of Economic Research, Inc.
  6. Andrew Epstein & Scott Johnson, 2012. "Physician response to financial incentives when choosing drugs to treat breast cancer," International Journal of Health Care Finance and Economics, Springer, vol. 12(4), pages 285-302, December.
  7. Arndt R. Reicher & Magdalena Stroka, 2014. "Nursing Home Prices and Quality of Care - Evidence from Administrative Data," Ruhr Economic Papers 0470, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
  8. Long, Qian & Klemetti, Reija & Wang, Yang & Tao, Fangbiao & Yan, Hong & Hemminki, Elina, 2012. "High caesarean section rate in rural China: Is it related to health insurance (New Co-operative Medical Scheme)?," Social Science & Medicine, Elsevier, vol. 75(4), pages 733-737.
  9. Kauhanen, Antti & Salmi, Julia & Torkki, Paulus, 2013. "Performance Measurement in Healthcare Incentive Plans," ETLA Working Papers 18, The Research Institute of the Finnish Economy.
  10. Mireille Jacobson & Tom Y. Chang & Joseph P. Newhouse & Craig C. Earle, M.D., 2013. "Physician Agency and Competition: Evidence from a Major Change to Medicare Chemotherapy Reimbursement Policy," NBER Working Papers 19247, National Bureau of Economic Research, Inc.
  11. Grytten, Jostein & Skau, Irene & Sørensen, Rune, 2011. "Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics," Journal of Health Economics, Elsevier, vol. 30(1), pages 163-180, January.

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