Do expert patients get better treatment than others? Agency discrimination and statistical discrimination in obstetrics
We address models that can explain why expert patients (obstetricians, midwives and doctors) are treated better than non-experts (mainly non-medical training). Models of statistical discrimination show that benevolent doctors treat expert patients better, since experts are better at communicating with the doctor. Agency theory suggests that doctors have an incentive to limit hospital costs by distorting information to non-expert patients, but not to expert patients. The hypotheses were tested on a large set of data, which contained information about the highest education of the parents, and detailed medical information about all births in Norway during the period 1967-2005 (Medical Birth Registry). The empirical analyses show that expert parents have a higher rate of Caesarean section than non-expert parents. The educational disparities were considerable 40 years ago, but have become markedly less over time. The analyses provide support for statistical discrimination theory, though agency theory cannot be totally excluded.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- 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.
- Andrew Epstein & Sean Nicholson, 2005. "The Formation And Evolution Of Physician Treatment Styles: An Application To Cesarean Sections," Working Papers id:176, eSocialSciences.
- 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.
- Jonathan Gruber & Maria Owings, 1994.
"Physician Financial Incentives and Cesarean Section Delivery,"
NBER Working Papers
4933, National Bureau of Economic Research, Inc.
- Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring.
- Darren Grant, 2008.
"Physician Financial Incentives and Cesarean Delivery: New Conclusions from the Healthcare Cost and Utilization Project,"
0801, Sam Houston State University, Department of Economics and International Business.
- 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.
- Lin, Herng-Ching & Xirasagar, Sudha & Kao, Senyeong, 2004. "Association of hospital ownership with patient transfers to outpatient care under a prospective payment system in Taiwan," Health Policy, Elsevier, vol. 69(1), pages 11-19, July.
- Leone, Tiziana & Padmadas, Sabu S. & Matthews, Zoë, 2008. "Community factors affecting rising caesarean section rates in developing countries: An analysis of six countries," Social Science & Medicine, Elsevier, vol. 67(8), pages 1236-1246, October.
- 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.
- Currie, Janet & Gruber, Jonathan, 1996. "Saving Babies: The Efficacy and Cost of Recent Changes in the Medicaid Eligibility of Pregnant Women," Journal of Political Economy, University of Chicago Press, vol. 104(6), pages 1263-96, December.
- Balsa, Ana I. & McGuire, Thomas G., 2003. "Prejudice, clinical uncertainty and stereotyping as sources of health disparities," Journal of Health Economics, Elsevier, vol. 22(1), pages 89-116, January.
- Brown, Iii, H. Shelton, 2007. "Lawsuit activity, defensive medicine, and small area variation: the case of cesarean sections revisited," Health Economics, Policy and Law, Cambridge University Press, vol. 2(03), pages 285-296, July.
- Dennis J. Aigner & Glen G. Cain, 1977. "Statistical theories of discrimination in labor markets," Industrial and Labor Relations Review, ILR Review, Cornell University, ILR School, vol. 30(2), pages 175-187, January.
- Arima, Yuzo & Guthrie, Brandon L. & Rhew, Isaac C. & De Roos, Anneclaire J., 2009. "The impact of the First Steps prenatal care program on birth outcomes among women receiving Medicaid in Washington State," Health Policy, Elsevier, vol. 92(1), pages 49-54, September.
When requesting a correction, please mention this item's handle: RePEc:eee:jhecon:v:30:y:2011:i:1:p:163-180. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei)
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 references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.