Access to Care, Provider Choice and Racial Disparities
This paper explores whether choice of provider explains any of the observed infant health gradients, and if so, why poor women choose different providers than their richer neighbors. We exploit an exogenous change in policy that occurred in California in the early 1990s that suddenly increased Medicaid payments to hospitals and which lead to a sharp change in where women with Medicaid delivered. To characterize the extent to which poor women responded to the increase in provider access, we calculate hospital segregation indices (which measure the extent to which Medicaid mothers delivered in separate hospitals than privately insured mothers residing in the same geographic area) both before and after the policy change for each market in California and show that it fell sharply after the policy change. Even though black mothers responded least to the increase in provider choice afforded by the policy change, they benefited the most from hospital desegregation in terms of reduced neonatal mortality and decreased incidence of very low birth weight. In contrast, other groups with lower initial neonatal mortality moved more and gained less in terms of improvements in birth outcomes.
|Date of creation:||Apr 2004|
|Date of revision:|
|Publication status:||published as Aizer, Anna, Adriana Lleras-Muney and Mark Stabile. "Access To Care, Provider Choice, And The Infant Health Gradient," American Economic Review, 2005, v95(2,May), 248-252.|
|Contact details of provider:|| Postal: National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.|
Web page: http://www.nber.org
More information through EDIRC
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.:
- Kenneth Y. Chay & Michael Greenstone, 1999.
"The Impact of Air Pollution on Infant Mortality: Evidence from Geographic Variation in Pollution Shocks Induced by a Recession,"
NBER Working Papers
7442, National Bureau of Economic Research, Inc.
- Kenneth Y. Chay & Michael Greenstone, 2003. "The Impact of Air Pollution on Infant Mortality: Evidence from Geographic Variation in Pollution Shocks Induced by a Recession," The Quarterly Journal of Economics, Oxford University Press, vol. 118(3), pages 1121-1167.
- Angus Deaton & Christina Paxson, 1999.
"Mortality, education, income and inequality among American cohorts,"
279, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- Angus S. Deaton & Christina Paxson, 2001. "Mortality, Education, Income, and Inequality among American Cohorts," NBER Chapters, in: Themes in the Economics of Aging, pages 129-170 National Bureau of Economic Research, Inc.
- Angus Deaton & Christina Paxson, 1999. "Mortality, Education, Income, and Inequality among American Cohorts," NBER Working Papers 7140, National Bureau of Economic Research, Inc.
- Mark G. Duggan, 2000.
"Hospital Ownership and Public Medical Spending,"
The Quarterly Journal of Economics,
Oxford University Press, vol. 115(4), pages 1343-1373.
- Janet Currie & Patricia Reagan, 1998. "Distance to Hospitals and Children's Access to Care: Is Being Closer Better, and for Whom?," NBER Working Papers 6836, National Bureau of Economic Research, Inc.
- S. Baranzoni & P. Bianchi & L. Lambertini, 2000. "Multiproduct Firms, Product Differentiation, and Market Structure," Working Papers 368, Dipartimento Scienze Economiche, Universita' di Bologna.
- David M. Cutler & Ellen Meara, 2000.
"The Technology of Birth: Is It Worth It?,"
in: Frontiers in Health Policy Research, Volume 3, pages 33-68
National Bureau of Economic Research, Inc.
- Mark Duggan, 2000. "Hospital Market Structure and the Behavior of Not-for-Profit Hospitals: Evidence from Responses to California's Disproportionate Share Program," NBER Working Papers 7966, National Bureau of Economic Research, Inc.
When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:10445. 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: ()
If references are entirely missing, you can add them using this form.