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The Effect of Maternity Ward Closures on Physician’s Practice and Health Outcomes in Japan

Author

Listed:
  • Akifumi Kusano

    (Graduate School of Economics, Waseda University; Waseda Institute of Social and Human Capital Studies (WISH), Tokyo, Japan)

  • Haruko Noguchi

    (Faculty of School of Political Science and Economics, Tokyo, Japan; WISH, Tokyo, Japan)

  • Yichen Shen

    (Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Kanagawa, Japan; WISH, Tokyo, Japan)

Abstract

The maternity ward closures are observing across many countries, yet little known about how the closures affect obstetrician behavior and delivery practices. The unique institutional setting in Japan, exclusion of natural delivery from public health insurance, creates a unique institutional setting for analyzing physician’s delivery practices. This study analyzes the effect of hospital-based maternity ward closures on cesarean section practice and health outcomes. Using the Survey of Medical Institutions and Vital Statistics and employing a staggered difference-in-differences, we show that clinics increased the rate of cesarean section regardless of risk-factors of cesarean delivery. Moreover, this result was driven by private clinics. We interpret this result as evidence of overuse of cesarean sections that was caused by physician’s profit-maximizing behavior. Our findings imply that the expansion of insurance coverage for delivery care can mitigate this unintended effect.

Suggested Citation

  • Akifumi Kusano & Haruko Noguchi & Yichen Shen, 2025. "The Effect of Maternity Ward Closures on Physician’s Practice and Health Outcomes in Japan," Working Papers 2520, Waseda University, Faculty of Political Science and Economics.
    • Handle: RePEc:wap:wpaper:2520
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    Keywords

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    JEL classification:

    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • J1 - Labor and Demographic Economics - - Demographic Economics

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