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Is there 'patient selection' in the demand for private maternity care in Greece?

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  • Elias Mossialos
  • Joan Costa-Font
  • Konstantina Davaki
  • Konstantinos Karras

Abstract

The influence of private health insurance (PHI) and gynaecologists' demand for leisure in determining a caesarean section (CS) delivery is examined. A database collected in January 2002 is exploited which contains records on women who attended the second largest private hospital in Greece. A joint maximum-likelihood probit estimation for the PHI subscription and the decision to undertake CS is employed. Results suggest that the obstetrician's decision to undertake CS is not independent of the women having PHI coverage. The probability of a CS taking place increases by about 20% if mothers have PHI. Furthermore, CS deliveries were more likely to take place between 12.00 and 16.00 pm and on working week days and Saturdays. The results support the hypothesis of patient selection on the basis of holding PHI and exhibit evidence of gynaecologists' 'demand for leisure'.

Suggested Citation

  • Elias Mossialos & Joan Costa-Font & Konstantina Davaki & Konstantinos Karras, 2005. "Is there 'patient selection' in the demand for private maternity care in Greece?," Applied Economics Letters, Taylor & Francis Journals, vol. 12(1), pages 7-12.
    • Handle: RePEc:taf:apeclt:v:12:y:2005:i:1:p:7-12
    DOI: 10.1080/13504850420007099
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    References listed on IDEAS

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    1. Propper, Carol, 1993. "Constrained choice sets in the U.K. demand for private medical insurance," Journal of Public Economics, Elsevier, vol. 51(3), pages 287-307, July.
    2. Thomas G. McGuire & Mark V. Pauly, 1991. "Physician Response to Fee Changes with Multiple Payers," Papers 0015, Boston University - Industry Studies Programme.
    3. Francome, Colin & Savage, Wendy, 1993. "Caesarean section in Britain and the United States 12% or 24%: Is either the right rate?," Social Science & Medicine, Elsevier, vol. 37(10), pages 1199-1218, November.
    4. 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.
    5. McGuire, Thomas G. & Pauly, Mark V., 1991. "Physician response to fee changes with multiple payers," Journal of Health Economics, Elsevier, vol. 10(4), pages 385-410.
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    Cited by:

    1. Węgrzynowska, Maria & Nenko, Ilona & Raczkiewicz, Dorota & Baranowska, Barbara, 2023. "Investment in the peace of mind? How private services change the landscape of maternity care in Poland," Social Science & Medicine, Elsevier, vol. 337(C).
    2. Leo Turcotte & John Robst & Solomon Polachek, 2006. "Medical interventions among pregnant women in fee-for-service and managed care insurance: a propensity score analysis," Applied Economics, Taylor & Francis Journals, vol. 38(13), pages 1513-1525.

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