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Comportamiento médico: una aplicación a las cesáreas en el Uruguay

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Author Info

  • Leonel Muinelo

    (Departmento de Economía, Facultad de Ciencias Sociales, Universidad de la República)

  • Máximo Rossi

    (Departmento de Economía, Facultad de Ciencias Sociales, Universidad de la República)

  • Patricia Triunfo

    (Departmento de Economía, Facultad de Ciencias Sociales, Universidad de la República)

Abstract

In Uruguay, as all over the world, the Caesarean section rate has been systematically increasing, and in 2003 it reached 23 per cent of the deliveries in public hospitals and 42 per cent in private hospitals. Considering deliveries registered in 2003 (23.474) by the Perinatal Information System (PIS) in Montevideo (Uruguay), the probability of having a Caesarean section delivery is estimated, controlled by risk factors and the endogeneity of the choice of hospital. At Montevideo private hospitals this procedure has to be paid for whereas public hospitals have fixed budget payment systems. As theory predicts, in the former there is no effect of income over induction, but in private hospitals this effect is positive, and is lower in cases where there is less medical risk. As a result, probability differences may confirm the induced demand hypothesis in Caesarean section deliveries. The empirical work yields evidence to say that there is 20 per cent of probability for a woman having a Caesarean section delivery in a public hospital, while in private hospitals the probability rises to 40 per cent. At the same time, differences between the two types of hospitals get bigger for lower risk women. For example, the probability of having a new Caesarean section delivery for those with a previous one is 64 per cent in public institutions versus 83 per cent in private institutions. However, women considered to have no medical risk have double the probability of a Caesarean section in private hospitals than in public ones (26 per cent versus 11 per cent).

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Bibliographic Info

Paper provided by Department of Economics - dECON in its series Documentos de Trabajo (working papers) with number 0605.

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Length: 36 pages
Date of creation: Nov 2005
Date of revision:
Handle: RePEc:ude:wpaper:0605

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Keywords: health; induced demand; cesarean section delivery; exogeneity testing;

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References

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  1. 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.
  2. Victor R. Fuchs, 1978. "The Supply of Surgeons and the Demand for Operations," NBER Working Papers 0236, National Bureau of Economic Research, Inc.
  3. Dranove, David & Wehner, Paul, 1994. "Physician-induced demand for childbirths," Journal of Health Economics, Elsevier, vol. 13(1), pages 61-73, March.
  4. Phelps, Charles E., 1986. "Induced demand -- can we ever know its extent?," Journal of Health Economics, Elsevier, vol. 5(4), pages 355-365, December.
  5. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
  6. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
  7. Eckerlund, Ingemar & Gerdtham, Ulf-G, 1996. "Variation in cesarean section rates in Sweden - Causes and economic consequences," Working Paper Series in Economics and Finance 106, Stockholm School of Economics.
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Cited by:
  1. Tavares, Aida Isabel & Rocha, Tania, 2012. "The demand factors for cesareans in Portugal – some preliminary results," MPRA Paper 43585, University Library of Munich, Germany.

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