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The Health Impacts of Hospital Delivery Practices

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  • David Card
  • Alessandra Fenizia
  • David Silver

Abstract

Treatment practices vary widely across hospitals, often with little connection to the medical needs of patients. We assess impacts of these differences in childbirth, where there is broad interest in reducing cesarean deliveries. Using a distance-based design and data from half a million births, we find that infants delivered at hospitals with higher c-section rates are born in better shape, are less likely to be readmitted to the hospital, are exhibit suggestive evidence of improved survival. These benefits are driven by the avoidance of prolonged labors that pose serious risks to infant health. In contrast, we document that these infants are substantially more likely to return to the emergency department for respiratory-related problems in the year after birth, providing some of the first design-based evidence consistent with a large observational literature linking cesarean delivery to chronic reductions in respiratory health.

Suggested Citation

  • David Card & Alessandra Fenizia & David Silver, 2019. "The Health Impacts of Hospital Delivery Practices," NBER Working Papers 25986, National Bureau of Economic Research, Inc.
  • Handle: RePEc:nbr:nberwo:25986
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    4. Daniel Auer & Johannes S. Kunz, 2021. "Communication Barriers and Infant Health: Intergenerational Effects of Randomly Allocating Refugees Across Language Regions," SoDa Laboratories Working Paper Series 2021-07, Monash University, SoDa Laboratories.
    5. Tafti, Elena Ashtari, 2023. "Technology, Skills, and Performance: The Case of Robots in Surgery," CINCH Working Paper Series (since 2020) 78746, Duisburg-Essen University Library, DuEPublico.
    6. Kenneth Lee & Edward Miguel & Catherine Wolfram, 2020. "Does Household Electrification Supercharge Economic Development?," Journal of Economic Perspectives, American Economic Association, vol. 34(1), pages 122-144, Winter.
    7. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    8. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    9. Syed Hasan & Tasnima Akter & Musharrat Jahan & Ashraf Dewan, 2023. "Proximity to healthcare centres and service use: The case of Community Clinics in Bangladesh," Economics of Transition and Institutional Change, John Wiley & Sons, vol. 31(3), pages 819-849, July.
    10. Carolina Melo & Naercio Menezes‐Filho, 2024. "The effect of birth timing manipulation around carnival on birth indicators in Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 33(9), pages 2013-2058, September.
    11. Yu, Serena & Fiebig, Denzil G. & Viney, Rosalie & Scarf, Vanessa & Homer, Caroline, 2022. "Private provider incentives in health care: The case of caesarean births," Social Science & Medicine, Elsevier, vol. 294(C).
    12. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    13. Hanna Mühlrad, 2022. "Cesarean sections for high‐risk births: health, fertility, and labor market outcomes," Scandinavian Journal of Economics, Wiley Blackwell, vol. 124(4), pages 1056-1086, October.
    14. Elena Ashtari Tafti, 2022. "Technology, skills, and performance: the case of robots in surgery," IFS Working Papers W22/46, Institute for Fiscal Studies.
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    JEL classification:

    • D22 - Microeconomics - - Production and Organizations - - - Firm Behavior: Empirical Analysis
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth

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