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¿Son los cuidados prenatales efectivos? Un enfoque con datos individuales de panel

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Author Info

  • Ana Inés Balsa

    ()
    (Departamento de Economía y Centro de Investigaciones Aplicadas Facultad de Ciencias Empresariales y Economía. Universidad de Montevideo.)

  • Patricia Triunfo

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

Abstract

This paper analyzes the impact of prenatal care on low birth weight and pre-term births using panel data on births that took place between 1995 and 2008 in the largest public university hospital in Uruguay (Perinatal Information System, PAHO). The hospital provides free access to prenatal and obstetric care and serves 15% of deliveries in the country. The use of difference-GMM estimation addresses potential biases due to time invariant unobserved heterogeneity and feedback effects from prior pregnancies to the current demand of prenatal inputs. Our results show that if pregnant women initiated prenatal care in the first trimester and had at least 6 controls (which is the goal of the Uruguayan National Health Insurance System) the likelihood of low birth weight would decrease by 3 percentage points, a 30% decrease. Our estimates underscore the importance of controlling for unobserved heterogeneity and feedback effects. They are also larger than others exploiting health policy changes in 2SLS settings. In this sense, our results are in line with the critique that local average treatment effects identified by 2SLS may fail to consider the bimodality of the pregnancy distribution and underestimate the effects of interest.

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File URL: http://www.fcs.edu.uy/archivos/0612.pdf
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Bibliographic Info

Paper provided by Department of Economics - dECON in its series Documentos de Trabajo (working papers) with number 0612.

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Length: 39 pages
Date of creation: Jun 2012
Date of revision:
Handle: RePEc:ude:wpaper:0612

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Keywords: prenatal care; panel data; difference GMM; low birth weight; low SES populations;

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References

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  1. David Roodman, 2006. "How to Do xtabond2: An Introduction to "Difference" and "System" GMM in Stata," Working Papers 103, Center for Global Development.
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  11. Currie, Janet & Grogger, Jeffrey, 2002. "Medicaid expansions and welfare contractions: offsetting effects on prenatal care and infant health?," Journal of Health Economics, Elsevier, vol. 21(2), pages 313-335, March.
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  13. Partha Deb & Karen Smith Conway, 2002. "Is Prenatal Care Really Ineffective? Or, is the 'Devil' in the Distribution?," Hunter College Department of Economics Working Papers 02/2, Hunter College: Department of Economics.
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  16. Nancy E. Reichman & Hope Corman & Kelly Noonan & Dhaval Dave, 2009. "Infant health production functions: what a difference the data make," Health Economics, John Wiley & Sons, Ltd., vol. 18(7), pages 761-782.
  17. George L. Wehby & Jeffrey C. Murray & Eduardo E. Castilla & Jorge S. Lopez-Camelo & Robert L. Ohsfeldt, 2009. "Quantile effects of prenatal care utilization on birth weight in Argentina," Health Economics, John Wiley & Sons, Ltd., vol. 18(11), pages 1307-1321.
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  19. Guilkey, David K. & Popkin, Barry M. & Akin, John S. & Wong, Emelita L., 1989. "Prenatal care and pregnancy outcome in Cebu, Philippines," Journal of Development Economics, Elsevier, vol. 30(2), pages 241-272, April.
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