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Caesarean section and the manipulation of exact delivery time

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  • Fabbri, D.
  • Monfardini, C.
  • Castaldini, I.
  • Protonotari, A.

Abstract

Physicians are often alleged responsible for the manipulation of delivery timing. We investigate this issue in a setting that negates the influence of financial incentives behind “physician’s demand induction†but allows for “risk aversion†to medical errors and “demand for leisure†motivations. Working on a sample of women admitted at the onset of labor in a big public hospital in Italy we estimate a model for the exact time of delivery as driven by individual indication to receive Caesarean Section (CS) and covariates. We find that ICS does not affect the day of delivery but leads to a circadian rhythm in the likelihood of delivery. The pattern is consistent with the postponement of high ICS deliveries in the late night\early morning shift. Our evidence hardly supports the manipulation of timing of births as driven by medical staff’s “demand for leisure†. An explanationbased on “risk aversion†attitude seems more appropriate.

Suggested Citation

  • Fabbri, D. & Monfardini, C. & Castaldini, I. & Protonotari, A., 2015. "Caesarean section and the manipulation of exact delivery time," Health, Econometrics and Data Group (HEDG) Working Papers 15/25, HEDG, c/o Department of Economics, University of York.
  • Handle: RePEc:yor:hectdg:15/25
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    References listed on IDEAS

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    1. Gans, Joshua S. & Leigh, Andrew, 2009. "Born on the first of July: An (un)natural experiment in birth timing," Journal of Public Economics, Elsevier, vol. 93(1-2), pages 246-263, February.
    2. Kasey S. Buckles & Daniel M. Hungerman, 2013. "Season of Birth and Later Outcomes: Old Questions, New Answers," The Review of Economics and Statistics, MIT Press, vol. 95(3), pages 711-724, July.
    3. Michael Neugart & Henry Ohlsson, 2013. "Economic incentives and the timing of births: evidence from the German parental benefit reform of 2007," Journal of Population Economics, Springer;European Society for Population Economics, vol. 26(1), pages 87-108, January.
    4. Lo, Joan C., 2003. "Patients' attitudes vs. physicians' determination: implications for cesarean sections," Social Science & Medicine, Elsevier, vol. 57(1), pages 91-96, July.
    5. Joshua S. Gans & Andrew Leigh, 2012. "Bargaining Over Labour: Do Patients Have Any Power?," The Economic Record, The Economic Society of Australia, vol. 88(281), pages 182-194, June.
    6. Brown, H. III, 1996. "Physician demand for leisure: implications for cesarean section rates," Journal of Health Economics, Elsevier, vol. 15(2), pages 233-242, April.
    7. Lefevre, M., 2014. "Physician induced demand for C-sections: does the convenience incentive matter?," Health, Econometrics and Data Group (HEDG) Working Papers 14/08, HEDG, c/o Department of Economics, University of York.
    8. Gans, Joshua S. & Leigh, Andrew & Varganova, Elena, 2007. "Minding the shop: The case of obstetrics conferences," Social Science & Medicine, Elsevier, vol. 65(7), pages 1458-1465, October.
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    1. repec:eee:socmed:v:196:y:2018:i:c:p:86-95 is not listed on IDEAS

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    Keywords

    timing of delivery; physician incentives; caesarean section; scheduling;

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • L23 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Organization of Production
    • C35 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Discrete Regression and Qualitative Choice Models; Discrete Regressors; Proportions
    • C51 - Mathematical and Quantitative Methods - - Econometric Modeling - - - Model Construction and Estimation

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