The Health Impacts of Hospital Delivery Practices

79 Pages Posted: 27 Jun 2019

See all articles by David Card

David Card

University of California, Berkeley - Department of Economics; Institute for the Study of Labor (IZA); National Bureau of Economic Research (NBER)

Alessandra Fenizia

UC Berkeley, Department of Economics

David Silver

Princeton University - Department of Economics

Multiple version iconThere are 2 versions of this paper

Date Written: June 2019

Abstract

Hospital treatment practices vary widely, often with little connection to the medical needs of patients. We assess the impact of these differences in the context of childbirth. We focus on low-risk first births, where c-section rates vary enormously across hospitals, and where policymakers have focused much of their attention in calls for reducing unnecessary c-sections. We find that proximity to hospitals with high c-section rates leads to more cesarean deliveries, fewer vaginal births after prolonged labor, and higher average Apgar scores. Infants born in these hospitals are less likely to be readmitted in the year after birth, but more likely to visit the emergency department for a respiratory-related problem. They also have lower mortality rates, driven by a reduction in the joint probability of prolonged labor and subsequent death. A stylized cost benefit analysis suggests that re-allocating births to high c-section hospitals could lead to net social benefits.

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Suggested Citation

Card, David E. and Fenizia, Alessandra and Silver, David, The Health Impacts of Hospital Delivery Practices (June 2019). NBER Working Paper No. w25986. Available at SSRN: https://ssrn.com/abstract=3410187

David E. Card (Contact Author)

University of California, Berkeley - Department of Economics ( email )

Room 3880
Berkeley, CA 94720-3880
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Institute for the Study of Labor (IZA)

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National Bureau of Economic Research (NBER)

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Alessandra Fenizia

UC Berkeley, Department of Economics ( email )

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Berkeley, CA 94709
United States

David Silver

Princeton University - Department of Economics ( email )

Princeton, NJ 08544-1021
United States

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