IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v120y2016i7p780-789.html
   My bibliography  Save this article

Cesarean section and the manipulation of exact delivery time

Author

Listed:
  • Fabbri, Daniele
  • Monfardini, Chiara
  • Castaldini, Ilaria
  • Protonotari, Adalgisa

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 on physician's behavior. 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 Cesarean Section (ICS) 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”. Physicians seem to manipulate the exact timing of delivery to reduce exposure to risk factors extant during off-peak periods.

Suggested Citation

  • Fabbri, Daniele & Monfardini, Chiara & Castaldini, Ilaria & Protonotari, Adalgisa, 2016. "Cesarean section and the manipulation of exact delivery time," Health Policy, Elsevier, vol. 120(7), pages 780-789.
    • Handle: RePEc:eee:hepoli:v:120:y:2016:i:7:p:780-789
    DOI: 10.1016/j.healthpol.2016.05.001
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851016301154
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2016.05.001?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Ayala Cohen, 1983. "Seasonal Daily Effect on the Number of Births in Israel," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 32(3), pages 228-235, November.
    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. 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.
    6. 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.
    7. 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.
    8. 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.
    9. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Okeke, Edward N. & Chari, A.V., 2018. "Health care at birth and infant mortality: Evidence from nighttime deliveries in Nigeria," Social Science & Medicine, Elsevier, vol. 196(C), pages 86-95.
    2. Carolina Melo & Naercio Menezes‐Filho, 2024. "The effect of birth timing manipulation around carnival on birth indicators in Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 33(9), pages 2013-2058, September.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Carolina Melo & Naercio Menezes‐Filho, 2024. "The effect of birth timing manipulation around carnival on birth indicators in Brazil," Health Economics, John Wiley & Sons, Ltd., vol. 33(9), pages 2013-2058, September.
    2. 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.
    3. Schulkind, Lisa & Shapiro, Teny Maghakian, 2014. "What a difference a day makes: Quantifying the effects of birth timing manipulation on infant health," Journal of Health Economics, Elsevier, vol. 33(C), pages 139-158.
    4. 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.
    5. Gabriela Aparicio & Paul E. Carrillo & M. Shahe Emran, 2013. "Are Sunday Babies Doomed for Life? Measuring the Sunday-Born Achievement Gap in Ecuador," Working Papers 2013-2, The George Washington University, Institute for International Economic Policy.
    6. Sara LaLumia & James M. Sallee & Nicholas Turner, 2015. "New Evidence on Taxes and the Timing of Birth," American Economic Journal: Economic Policy, American Economic Association, vol. 7(2), pages 258-293, May.
    7. Nicolas Moreau, 2023. "The zero effect of income tax on the timing of birth: some evidence on French data," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 30(3), pages 757-783, June.
    8. Almond, Douglas & Chee, Christine Pal & Sviatschi, Maria Micaela & Zhong, Nan, 2015. "Auspicious birth dates among Chinese in California," Economics & Human Biology, Elsevier, vol. 18(C), pages 153-159.
    9. Frodermann, Corinna & Wrohlich, Katharina & Zucco, Aline, 2023. "Parental Leave Policy and Long-run Earnings of Mothers," Labour Economics, Elsevier, vol. 80(C).
    10. Cheng Huang & Xiaojing Ma & Shiying Zhang & Qingguo Zhao, 2020. "Numerological preferences, timing of births and the long-term effect on schooling," Journal of Population Economics, Springer;European Society for Population Economics, vol. 33(2), pages 531-554, April.
    11. Nicolas Moreau, 2021. "The Zero Effect of Income Tax on the Timing of Birth: Some Evidence on French Data," TEPP Working Paper 2021-03, TEPP.
    12. Nicolas Moreau, 2021. "The Zero Effect of Income Tax on the Timing of Birth: Some Evidence on French Data," Working Papers hal-03157256, HAL.
    13. Huang, Cheng & Zhang, Shiying & Zhao, Qingguo & Lin, Yan, 2021. "Dragon year superstition, birth timing, and neonatal health outcomes," China Economic Review, Elsevier, vol. 66(C).
    14. Huzeyfe Torun & Semih Tumen, 2017. "The empirical content of season-of-birth effects: An investigation with Turkish data," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 37(57), pages 1825-1860.
    15. Nathan Deutscher & Robert Breunig, 2018. "Baby Bonuses: Natural Experiments in Cash Transfers, Birth Timing and Child Outcomes," The Economic Record, The Economic Society of Australia, vol. 94(304), pages 1-24, March.
    16. Damian Clarke & Sonia Oreffice & Climent Quintana‐Domeque, 2019. "The demand for season of birth," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 34(5), pages 707-723, August.
    17. 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.
    18. Corinna Frodermann & Katharina Wrohlich & Aline Zucco, 2020. "Parental Leave Reform and Long-Run Earnings of Mothers," Discussion Papers of DIW Berlin 1847, DIW Berlin, German Institute for Economic Research.
    19. Andreas Thiemann, 2015. "Pension Wealth and Maternal Employment: Evidence from a Reform of the German Child Care Pension Benefit," Discussion Papers of DIW Berlin 1499, DIW Berlin, German Institute for Economic Research.
    20. Beatrice Brunner & Andreas Kuhn, 2014. "Announcement effects of health policy reforms: evidence from the abolition of Austria’s baby bonus," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(4), pages 373-388, May.

    More about this item

    Keywords

    Timing of delivery; Physician incentives; Cesarean section; Scheduling;
    All these keywords.

    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

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:120:y:2016:i:7:p:780-789. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.