IDEAS home Printed from https://ideas.repec.org/a/bla/ijhplm/v36y2021i5p1626-1652.html
   My bibliography  Save this article

The effects of health insurance on the choice of medical procedures: Evidence from heart attacks and childbirths

Author

Listed:
  • Marco A. Castaneda
  • Meryem Saygili

Abstract

This paper investigates the effect of health insurance on the use of alternative procedures to treat a given medical condition. In particular, we estimate the effect of health insurance on the use of bypass surgery after a heart attack and on the use of a C‐section after a normal pregnancy. These procedures are the most expensive, compared to the alternatives. Theoretically, the demand for some procedures like bypass surgery is likely to be inelastic. In this situation, health insurance should have no effect on the use of the procedure. For other procedures such as C‐section, demand may be more elastic, especially after a normal pregnancy without complications. We use a nationally representative dataset of inpatient hospital admissions from the United States and control for individual and hospital characteristics. The results from our empirical analysis support our predictions. For patients admitted to a hospital because of a heart attack, being uninsured has no effect on the probability of bypass surgery. However, for patients admitted for childbirth, the uninsured have a substantially lower probability of a C‐section delivery.

Suggested Citation

  • Marco A. Castaneda & Meryem Saygili, 2021. "The effects of health insurance on the choice of medical procedures: Evidence from heart attacks and childbirths," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(5), pages 1626-1652, September.
    • Handle: RePEc:bla:ijhplm:v:36:y:2021:i:5:p:1626-1652
    DOI: 10.1002/hpm.3248
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hpm.3248
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hpm.3248?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Cutler, David M., 2007. "The lifetime costs and benefits of medical technology," Journal of Health Economics, Elsevier, vol. 26(6), pages 1081-1100, December.
    2. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
    3. Marco A. Castaneda & Meryem Saygili, 2016. "The health conditions and the health care consumption of the uninsured," Health Economics Review, Springer, vol. 6(1), pages 1-19, December.
    4. 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.
    5. Katherine Baicker & Dana Goldman, 2011. "Patient Cost-Sharing and Healthcare Spending Growth," Journal of Economic Perspectives, American Economic Association, vol. 25(2), pages 47-68, Spring.
    6. David M. Cutler & Mark B. McClellan & Joseph P. Newhouse & Dahlia K. Remler, 2001. "Pricing Heart Attack Treatments," NBER Chapters, in: Medical Care Output and Productivity, pages 305-362, National Bureau of Economic Research, Inc.
    7. Sloan, Frank A. & Shadle, John H., 2009. "Is there empirical evidence for "Defensive Medicine"? A reassessment," Journal of Health Economics, Elsevier, vol. 28(2), pages 481-491, March.
    8. Dale Tussing, A. & Wojtowycz, Martha A., 1993. "The effect of physician characteristics on clinical behavior: Cesarean section in New York State," Social Science & Medicine, Elsevier, vol. 37(10), pages 1251-1260, November.
    9. David M. Cutler & Ernst R. Berndt, 2001. "Medical Care Output and Productivity," NBER Books, National Bureau of Economic Research, Inc, number cutl01-1, March.
    10. Cutler, David, 2007. "The Lifetime Costs and Benefits of Medical Technology," Scholarly Articles 2643640, Harvard University Department of Economics.
    11. Grant, Darren, 2009. "Physician financial incentives and cesarean delivery: New conclusions from the healthcare cost and utilization project," Journal of Health Economics, Elsevier, vol. 28(1), pages 244-250, January.
    12. Joseph J. Doyle, 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," The Review of Economics and Statistics, MIT Press, vol. 87(2), pages 256-270, May.
    13. 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.
    14. Cai, W.-W. & Marks, J.S. & Chen, C.H.C. & Zhuang, Y.-X. & Morris, L. & Harris, J.R., 1998. "Increased cesarean section rates and emerging patterns of health insurance in Shanghai, China," American Journal of Public Health, American Public Health Association, vol. 88(5), pages 777-780.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. 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.
    2. Jensen, Vibeke Myrup & Wüst, Miriam, 2015. "Can Caesarean section improve child and maternal health? The case of breech babies," Journal of Health Economics, Elsevier, vol. 39(C), pages 289-302.
    3. Guccio, C. & Lisi, D., 2014. "Social interactions in inappropriate behavior for childbirth services: Theory and evidence from the Italian hospital sector," Health, Econometrics and Data Group (HEDG) Working Papers 14/28, HEDG, c/o Department of Economics, University of York.
    4. 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).
    5. Guccio, Calogero & Lisi, Domenico, 2016. "Thus do all. Social interactions in inappropriate behavior for childbirth services in a highly decentralized healthcare system," Regional Science and Urban Economics, Elsevier, vol. 61(C), pages 1-17.
    6. Janet Currie & W. Bentley MacLeod, 2017. "Diagnosing Expertise: Human Capital, Decision Making, and Performance among Physicians," Journal of Labor Economics, University of Chicago Press, vol. 35(1), pages 1-43.
    7. Vasudeva N. R. Murthy & Natalya Ketenci, 2017. "Is technology still a major driver of health expenditure in the United States? Evidence from cointegration analysis with multiple structural breaks," International Journal of Health Economics and Management, Springer, vol. 17(1), pages 29-50, March.
    8. Yu, Serena & Fiebig, Denzil G. & Scarf, Vanessa & Viney, Rosalie & Dahlen, Hannah G. & Homer, Caroline, 2020. "Birth models of care and intervention rates: The impact of birth centres," Health Policy, Elsevier, vol. 124(12), pages 1395-1402.
    9. Ity Shurtz, 2014. "Malpractice Law, Physicians' Financial Incentives, and Medical Treatment: How Do They Interact?," Journal of Law and Economics, University of Chicago Press, vol. 57(1), pages 1-29.
    10. 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.
    11. Craig Garthwaite & Tal Gross & Matthew J. Notowidigdo, 2014. "Public Health Insurance, Labor Supply, and Employment Lock," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 129(2), pages 653-696.
    12. Jack, William & Lewis, Maureen, 2009. "Health investments and economic growth : macroeconomic evidence and microeconomic foundations," Policy Research Working Paper Series 4877, The World Bank.
    13. Erin Johnson & M. Marit Rehavi & David C. Chan, Jr & Daniela Carusi, 2016. "A Doctor Will See You Now: Physician-Patient Relationships and Clinical Decisions," NBER Working Papers 22666, National Bureau of Economic Research, Inc.
    14. Halla, Martin & Mayr, Harald & Pruckner, Gerald J. & García-Gómez, Pilar, 2020. "Cutting fertility? Effects of cesarean deliveries on subsequent fertility and maternal labor supply," Journal of Health Economics, Elsevier, vol. 72(C).
    15. Alejandro Arrieta & Ariadna García-Prado, 2012. "Non-elective cesarean sections in public hospitals: hospital capacity constraints and doctor´s incentives," Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra 1212, Departamento de Economía - Universidad Pública de Navarra.
    16. Contreras Juan & Patel Elena & Tristao Ignez, 2013. "Production Factors, Productivity Dynamics and Quality Gains as Determinants of Healthcare Spending Growth in U.S. Hospitals," Working Papers 2013-13, Banco de México.
    17. Joseph P. Newhouse, 2001. "Medical Care Price Indices: Problems and Opportunities / The Chung-Hua Lectures," NBER Working Papers 8168, National Bureau of Economic Research, Inc.
    18. Lan Thi Thu Phan & Yusuke Jinnai, 2018. "Does health insurance matter in the hospital? New evidence from patient-level medical records in Vietnam," Working Papers EMS_2018_01, Research Institute, International University of Japan.
    19. Avdic, Daniel, 2016. "Improving efficiency or impairing access? Health care consolidation and quality of care: Evidence from emergency hospital closures in Sweden," Journal of Health Economics, Elsevier, vol. 48(C), pages 44-60.
    20. Margaret Oppenheimer & Helen LaVan & William Martin, 2015. "A Framework for Understanding Ethical and Efficiency Issues in Pharmaceutical Intellectual Property Litigation," Journal of Business Ethics, Springer, vol. 132(3), pages 505-524, December.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ijhplm:v:36:y:2021:i:5:p:1626-1652. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0749-6753 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.