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Cesarean section and the manipulation of exact delivery time

Author

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  • Fabbri, Daniele
  • Monfardini, Chiara
  • Castaldini, Ilaria
  • Protonotari, Adalgisa

Abstract

Physicians are often alleged responsible for the manipulation of delivery timing. We investigate this issue in a setting that negates the influence of financial incentives on physician's behavior. Working on a sample of women admitted at the onset of labor in a big public hospital in Italy we estimate a model for the exact time of delivery as driven by individual Indication to Cesarean Section (ICS) and covariates. We find that ICS does not affect the day of delivery but leads to a circadian rhythm in the likelihood of delivery. The pattern is consistent with the postponement of high ICS deliveries in the late night\early morning shift. Our evidence hardly supports the manipulation of timing of births as driven by medical staff's “demand for leisure”. Physicians seem to manipulate the exact timing of delivery to reduce exposure to risk factors extant during off-peak periods.

Suggested Citation

  • Fabbri, Daniele & Monfardini, Chiara & Castaldini, Ilaria & Protonotari, Adalgisa, 2016. "Cesarean section and the manipulation of exact delivery time," Health Policy, Elsevier, vol. 120(7), pages 780-789.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:7:p:780-789
    DOI: 10.1016/j.healthpol.2016.05.001
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    1. Ayala Cohen, 1983. "Seasonal Daily Effect on the Number of Births in Israel," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 32(3), pages 228-235, November.
    2. Kasey S. Buckles & Daniel M. Hungerman, 2013. "Season of Birth and Later Outcomes: Old Questions, New Answers," The Review of Economics and Statistics, MIT Press, vol. 95(3), pages 711-724, July.
    3. Michael Neugart & Henry Ohlsson, 2013. "Economic incentives and the timing of births: evidence from the German parental benefit reform of 2007," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(1), pages 87-108, January.
    4. Lo, Joan C., 2003. "Patients' attitudes vs. physicians' determination: implications for cesarean sections," Social Science & Medicine, Elsevier, vol. 57(1), pages 91-96, July.
    5. Lefevre, M., 2014. "Physician induced demand for C-sections: does the convenience incentive matter?," Health, Econometrics and Data Group (HEDG) Working Papers 14/08, HEDG, c/o Department of Economics, University of York.
    6. Joshua S. Gans & Andrew Leigh, 2012. "Bargaining Over Labour: Do Patients Have Any Power?," The Economic Record, The Economic Society of Australia, vol. 88(281), pages 182-194, June.
    7. Gans, Joshua S. & Leigh, Andrew & Varganova, Elena, 2007. "Minding the shop: The case of obstetrics conferences," Social Science & Medicine, Elsevier, vol. 65(7), pages 1458-1465, October.
    8. Gans, Joshua S. & Leigh, Andrew, 2009. "Born on the first of July: An (un)natural experiment in birth timing," Journal of Public Economics, Elsevier, vol. 93(1-2), pages 246-263, February.
    9. Brown, H. III, 1996. "Physician demand for leisure: implications for cesarean section rates," Journal of Health Economics, Elsevier, vol. 15(2), pages 233-242, April.
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    Cited by:

    1. Okeke, Edward N. & Chari, A.V., 2018. "Health care at birth and infant mortality: Evidence from nighttime deliveries in Nigeria," Social Science & Medicine, Elsevier, vol. 196(C), pages 86-95.

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    More about this item

    Keywords

    Timing of delivery; Physician incentives; Cesarean section; Scheduling;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L23 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Organization of Production
    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • C51 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Construction and Estimation

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