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Is it good to be too light? Birth weight thresholds in hospital reimbursement systems

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  • Reif, Simon
  • Wichert, Sebastian
  • Wuppermann, Amelie

Abstract

Birth weight manipulation has been documented in per-case hospital reimbursement systems, in which hospitals receive more money for otherwise equal newborns with birth weight just below compared to just above specific birth weight thresholds. As hospitals receive more money for cases with weight below the thresholds, having a (reported) weight below a threshold could benefit the newborn. Also, these reimbursement thresholds overlap with diagnostic thresholds that have been shown to affect the quantity and quality of care that newborns receive. Based on the universe of hospital births in Germany from the years 2005–2011, we investigate whether weight below reimbursement relevant thresholds triggers different quantity and quality of care. We find that this is not the case, suggesting that hospitals’ financial incentives with respect to birth weight do not directly impact the care that newborns receive.

Suggested Citation

  • Reif, Simon & Wichert, Sebastian & Wuppermann, Amelie, 2018. "Is it good to be too light? Birth weight thresholds in hospital reimbursement systems," Journal of Health Economics, Elsevier, vol. 59(C), pages 1-25.
  • Handle: RePEc:eee:jhecon:v:59:y:2018:i:c:p:1-25
    DOI: 10.1016/j.jhealeco.2018.01.007
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    References listed on IDEAS

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    Cited by:

    1. Hafner, Lucas & Reif, Simon & Seebauer, Michael, 2017. "Physician behavior under prospective payment schemes: Evidence from artefactual field and lab experiments," FAU Discussion Papers in Economics 18/2017, Friedrich-Alexander University Erlangen-Nuremberg, Institute for Economics.
    2. Hennig-Schmidt, Heike & Jürges, Hendrik & Wiesen, Daniel, 2018. "Dishonesty in healthcare practice: A behavioral experiment on upcoding in neonatology," HERO On line Working Paper Series 2018:3, Oslo University, Health Economics Research Programme.

    More about this item

    Keywords

    Neonatal care; DRG upcoding; Quantity and quality of care;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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