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The Health Impacts of Hospital Delivery Practices

Author

Listed:
  • David Card
  • Alessandra Fenizia
  • David Silver

Abstract

Treatment practices vary widely across hospitals, often with little connection to patients' medical needs. We assess impacts of these differences in delivery practices at childbirth. We find that infants quasi-randomly delivered at hospitals with higher C-section rates are born in better shape and are less likely to be readmitted, with suggestive evidence of improved survival. These benefits are driven by avoidance of prolonged labors that pose risks to infant health. In contrast, these infants are more likely to visit the emergency department for respiratory-related problems, consistent with a large observational literature linking C-section to chronic reductions in respiratory health.

Suggested Citation

  • David Card & Alessandra Fenizia & David Silver, 2023. "The Health Impacts of Hospital Delivery Practices," American Economic Journal: Economic Policy, American Economic Association, vol. 15(2), pages 42-81, May.
    • Handle: RePEc:aea:aejpol:v:15:y:2023:i:2:p:42-81
    DOI: 10.1257/pol.20210034
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    Cited by:

    1. Fréget, Louis & Koch Gregersen, Maria, 2025. "Health and Economic Impacts of an Early Labor Induction Policy for High-BMI Mothers," CEPREMAP Working Papers (Docweb) 2501, CEPREMAP.
    2. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Neighborhoods, networks, and delivery methods," Journal of Health Economics, Elsevier, vol. 80(C).
    3. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    4. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    5. Di Giacomo, Marina & Perucca, Giovanni & Piacenza, Massimiliano & Turati, Gilberto, 2024. "Immigrants' clusters and unequal access to healthcare treatments," Regional Science and Urban Economics, Elsevier, vol. 109(C).
    6. Carolina Melo & Naercio Menezes‐Filho, 2024. "The effect of birth timing manipulation around carnival on birth indicators in Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 33(9), pages 2013-2058, September.
    7. Tafti, Elena Ashtari, 2023. "Technology, Skills, and Performance: The Case of Robots in Surgery," CINCH Working Paper Series (since 2020) 78746, Duisburg-Essen University Library, DuEPublico.
    8. Daniel Auer & Johannes S. Kunz, 2021. "Communication Barriers and Infant Health: Intergenerational Effects of Randomly Allocating Refugees Across Language Regions," Papers 2021-05, Centre for Health Economics, Monash University.
    9. Yu, Serena & Fiebig, Denzil G. & Viney, Rosalie & Scarf, Vanessa & Homer, Caroline, 2022. "Private provider incentives in health care: The case of caesarean births," Social Science & Medicine, Elsevier, vol. 294(C).
    10. Christian Posso & Jorge Tamayo & Arlen Guarin & Estefania Saravia, 2024. "Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes," Borradores de Economia 1269, Banco de la Republica de Colombia.
    11. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    12. Kenneth Lee & Edward Miguel & Catherine Wolfram, 2020. "Does Household Electrification Supercharge Economic Development?," Journal of Economic Perspectives, American Economic Association, vol. 34(1), pages 122-144, Winter.
    13. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    14. Marina Di Giacomo & Massimiliano Piacenza & Luca Salmasi & Gilberto Turati, 2024. "Understanding productivity in maternity wards," DISCE - Working Papers del Dipartimento di Economia e Finanza def134, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
    15. Maxim Alekseev & Xinjue, Lin, 2025. "Trade Policy in the Shadow of Conflict: The Case of Dual-Use Goods," CEPREMAP Working Papers (Docweb) 2502, CEPREMAP.
    16. Syed Hasan & Tasnima Akter & Musharrat Jahan & Ashraf Dewan, 2023. "Proximity to healthcare centres and service use: The case of Community Clinics in Bangladesh," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 31(3), pages 819-849, July.
    17. Atul Gupta & Sabrina T Howell & Constantine Yannelis & Abhinav Gupta, 2024. "Owner Incentives and Performance in Healthcare: Private Equity Investment in Nursing Homes," The Review of Financial Studies, Society for Financial Studies, vol. 37(4), pages 1029-1077.
    18. Elena Ashtari Tafti, 2022. "Technology, skills, and performance: the case of robots in surgery," IFS Working Papers W22/46, Institute for Fiscal Studies.
    19. Hanna Mühlrad, 2022. "Cesarean sections for high‐risk births: health, fertility, and labor market outcomes," Scandinavian Journal of Economics, Wiley Blackwell, vol. 124(4), pages 1056-1086, October.
    20. Di Giacomo, Marina & Piacenza, Massimiliano & Salmasi, Luca & Turati, Gilberto, 2025. "Understanding labour productivity in maternity wards," Labour Economics, Elsevier, vol. 96(C).
    21. Liran Einav & Amy Finkelstein & Neale Mahoney, 2025. "Producing Health: Measuring Value Added of Nursing Homes," Econometrica, Econometric Society, vol. 93(4), pages 1225-1264, July.
    22. Atul Gupta & Sabrina T Howell & Constantine Yannelis & Abhinav Gupta, 2021. "Does Private Equity Investment in Healthcare Benefit Patients? Evidence from Nursing Homes," Working Papers 2021-20, Becker Friedman Institute for Research In Economics.
    23. Menares, Felipe & Muñoz, Pablo, 2025. "The impact of standardized disease-specific healthcare coverage," Journal of Public Economics, Elsevier, vol. 242(C).

    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

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