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Provider Supply, Utilization, and Infant Health: Evidence from a Physician Distribution Policy

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  • Bladimir Carrillo
  • Jose Feres

Abstract

We analyze a policy that substantially expanded the supply of primary care physicians in Brazil. The program increased doctor visits across all age groups and led to greater utilization of doctors for prenatal care. However, these physicians replaced nurse visits for prenatal care without increasing the overall number of visits women receive. We find no evidence of gains in widely used metrics of infant health, including birth weight, gestation, and infant mortality. Together, these findings provide suggestive evidence that physicians and nurses may be good substitutes in the production function of infant health.

Suggested Citation

  • Bladimir Carrillo & Jose Feres, 2019. "Provider Supply, Utilization, and Infant Health: Evidence from a Physician Distribution Policy," American Economic Journal: Economic Policy, American Economic Association, vol. 11(3), pages 156-196, August.
    • Handle: RePEc:aea:aejpol:v:11:y:2019:i:3:p:156-96
    Note: DOI: 10.1257/pol.20170619
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    References listed on IDEAS

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    1. Richard K. Crump & V. Joseph Hotz & Guido W. Imbens & Oscar A. Mitnik, 2009. "Dealing with limited overlap in estimation of average treatment effects," Biometrika, Biometrika Trust, vol. 96(1), pages 187-199.
    2. James Heckman & Hidehiko Ichimura & Jeffrey Smith & Petra Todd, 1998. "Characterizing Selection Bias Using Experimental Data," Econometrica, Econometric Society, vol. 66(5), pages 1017-1098, September.
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    Citations

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    Cited by:

    1. Mateus Dias & Luiz Felipe Fontes, 2024. "The Effects of a Large-Scale Mental Health Reform: Evidence from Brazil," American Economic Journal: Economic Policy, American Economic Association, vol. 16(3), pages 257-289, August.
    2. Tamara Bischof & Boris Kaiser, 2021. "Who cares when you close down? The effects of primary care practice closures on patients," Health Economics, John Wiley & Sons, Ltd., vol. 30(9), pages 2004-2025, September.
    3. Colleen M. Carey & Sarah Miller & Laura R. Wherry, 2020. "The Impact of Insurance Expansions on the Already Insured: The Affordable Care Act and Medicare," American Economic Journal: Applied Economics, American Economic Association, vol. 12(4), pages 288-318, October.
    4. Godager , Geir & Scott, Anthony, 2023. "Physician Behavior and Health Outcomes," HERO Online Working Paper Series 2023:3, University of Oslo, Health Economics Research Programme.
    5. Jonas Minet Kinge & Jostein Grytten, 2021. "The impact of primary care physician density on perinatal health: Evidence from a natural experiment," Health Economics, John Wiley & Sons, Ltd., vol. 30(12), pages 2974-2994, December.
    6. Francisco Costa & Letícia Nunes & Fabio Miessi Sanches, 2024. "How to Attract Physicians to Underserved Areas? Policy Recommendations from a Structural Model," The Review of Economics and Statistics, MIT Press, vol. 106(1), pages 36-52, January.
    7. Marcelo Castro & Enlinson Mattos & Fernanda Patriota, 2021. "The effects of health spending on the propagation of infectious diseases," Health Economics, John Wiley & Sons, Ltd., vol. 30(10), pages 2323-2344, September.
    8. Christian Posso & Jorge Tamayo & Arlen Guarin & Estefania Saravia, 2024. "Luck of the Draw: The Causal Effect of Physicians on Birth Outcomes," Borradores de Economia 1269, Banco de la Republica de Colombia.
    9. Álvaro Robério de Souza Sá & Danyelle Karine Santos Branco, 2024. "Social fund and infant mortality: Evidence from an anti‐poverty policy in Northeast Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 33(4), pages 674-695, April.
    10. Wichmann, Bruno & Wichmann, Roberta, 2022. "COVID-19 and Indigenous health in the Brazilian Amazon," Economic Modelling, Elsevier, vol. 115(C).
    11. Bancalari, Antonella & Bernal, Pedro & Celhay, Pablo & Martinez, Sebastian & Sánchez, Maria Deni, 2023. "An Ounce of Prevention for a Pound of Cure: Efficiency of Community-Based Healthcare," IZA Discussion Papers 16350, Institute of Labor Economics (IZA).

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    More about this item

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • 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
    • J44 - Labor and Demographic Economics - - Particular Labor Markets - - - Professional Labor Markets and Occupations
    • O15 - Economic Development, Innovation, Technological Change, and Growth - - Economic Development - - - Economic Development: Human Resources; Human Development; Income Distribution; Migration

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