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Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the United States

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  • Stefanie Fischer
  • Heather Royer
  • Corey White

Abstract

Over the last few decades, health care services in the United States have become more geographically centralized. We study how the loss of hospital-based obstetric units in over 400 counties affects maternal and infant health via a difference-in-differences design. We find that closures lead mothers to experience a significant change in birth procedures such as inductions and C-sections. In contrast to concerns voiced in the public discourse, the effects on a range of maternal and infant health outcomes are negligible or slightly beneficial. While women travel farther to receive care, closures induce women to receive higher quality care.

Suggested Citation

  • Stefanie Fischer & Heather Royer & Corey White, 2024. "Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the United States," American Economic Journal: Applied Economics, American Economic Association, vol. 16(3), pages 113-141, July.
    • Handle: RePEc:aea:aejapp:v:16:y:2024:i:3:p:113-41
    DOI: 10.1257/app.20220341
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    More about this item

    JEL classification:

    • 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
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

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