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.|
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- 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.
- 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.
- 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.
- Angus S. Deaton & Christina Paxson, 2001.
"Mortality, Education, Income, and Inequality among American Cohorts,"
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," Working Papers 279, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
- Angus Deaton & Christina Paxson, 1999. "Mortality, Education, Income, and Inequality among American Cohorts," NBER Working Papers 7140, 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,
MIT Press, vol. 118(3), pages 1121-1167, August.
- 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.
- Mark Duggan, 2000.
"Hospital Ownership and Public Medical Spending,"
NBER Working Papers
7789, National Bureau of Economic Research, Inc.
- S. Baranzoni & P. Bianchi & L. Lambertini, 2000. "Market Structure," Working Papers 368, Dipartimento Scienze Economiche, Universita' di Bologna.
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