IDEAS home Printed from https://ideas.repec.org/a/taf/applec/v48y2016i49p4719-4731.html
   My bibliography  Save this article

Non-elective C-sections in public hospitals: capacity constraints and doctor incentives

Author

Listed:
  • Alejandro Arrieta
  • Ariadna García Prado

Abstract

Using administrative records of births from the Perinatal Surveillance System of the Peruvian Social Security System (ESSALUD), we test whether high admissions of pregnant women affected non-elective caesarean section (C-section) rates in the ESSALUD public hospitals during 2005–2006. We present a basic theoretical model that considers physician preferences for leisure and hospital capacity constraints, and test the model predictions. We find that physician demand for leisure increases the probability of C-sections in small and medium-size hospitals, while hospital capacity constraints set a limit on them. We discuss the policy implications as well as the policies implemented to avoid unnecessary C-sections.

Suggested Citation

  • Alejandro Arrieta & Ariadna García Prado, 2016. "Non-elective C-sections in public hospitals: capacity constraints and doctor incentives," Applied Economics, Taylor & Francis Journals, vol. 48(49), pages 4719-4731, October.
    • Handle: RePEc:taf:applec:v:48:y:2016:i:49:p:4719-4731
    DOI: 10.1080/00036846.2016.1164820
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1080/00036846.2016.1164820
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1080/00036846.2016.1164820?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 search for a different version of it.

    References listed on IDEAS

    as
    1. Ludwig Kuntz & Stefan Scholtes, 2000. "Measuring the Robustness of Empirical Efficiency Valuations," Management Science, INFORMS, vol. 46(6), pages 807-823, June.
    2. Eckerlund, Ingemar & Gerdtham, Ulf-G, 1996. "Variation in cesarean section rates in Sweden - Causes and economic consequences," SSE/EFI Working Paper Series in Economics and Finance 106, Stockholm School of Economics.
    3. Evans, William N. & Kim, Beomsoo, 2006. "Patient outcomes when hospitals experience a surge in admissions," Journal of Health Economics, Elsevier, vol. 25(2), pages 365-388, March.
    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. Jonathan Gruber & Maria Owings, 1996. "Physician Financial Incentives and Cesarean Section Delivery," RAND Journal of Economics, The RAND Corporation, vol. 27(1), pages 99-123, Spring.
    6. Gruber, Jon & Kim, John & Mayzlin, Dina, 1999. "Physician fees and procedure intensity: the case of cesarean delivery," Journal of Health Economics, Elsevier, vol. 18(4), pages 473-490, August.
    7. Arrieta, Alejandro & García-Prado, Ariadna & Guillén, Jorge, 2011. "The Private Health Care Sector and the Provision of Prenatal Care Services in Latin America," World Development, Elsevier, vol. 39(4), pages 579-587, April.
    8. Dubay, Lisa & Kaestner, Robert & Waidmann, Timothy, 1999. "The impact of malpractice fears on cesarean section rates," Journal of Health Economics, Elsevier, vol. 18(4), pages 491-522, August.
    9. Keeler, Theodore E & Ying, John S, 1996. "Hospital Costs and Excess Bed Capacity: A Statistical Analysis," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 470-481, August.
    10. Li, Ling & Benton, W. C., 2003. "Hospital capacity management decisions: Emphasis on cost control and quality enhancement," European Journal of Operational Research, Elsevier, vol. 146(3), pages 596-614, May.
    11. Jeffrey E. Harris, 1977. "The Internal Organization of Hospitals: Some Economic Implications," Bell Journal of Economics, The RAND Corporation, vol. 8(2), pages 467-482, Autumn.
    12. Patricia Triunfo & Máximo Rossi, 2009. "The effect of physicians’ remuneration system on the Caesarean section rate: the Uruguayan case," International Journal of Health Economics and Management, Springer, vol. 9(4), pages 333-345, December.
    13. Ludwig Kuntz & Stefan Scholtes & Antonio Vera, 2007. "Incorporating efficiency in hospital-capacity planning in Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(3), pages 213-223, September.
    14. Lo, Joan C., 2003. "Patients' attitudes vs. physicians' determination: implications for cesarean sections," Social Science & Medicine, Elsevier, vol. 57(1), pages 91-96, July.
    15. Lo, Joan C., 2008. "Financial incentives do not always work--An example of cesarean sections in Taiwan," Health Policy, Elsevier, vol. 88(1), pages 121-129, October.
    16. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    17. Sarkis, Joseph, 2000. "A comparative analysis of DEA as a discrete alternative multiple criteria decision tool," European Journal of Operational Research, Elsevier, vol. 123(3), pages 543-557, June.
    18. Litvak, Nelly & van Rijsbergen, Marleen & Boucherie, Richard J. & van Houdenhoven, Mark, 2008. "Managing the overflow of intensive care patients," European Journal of Operational Research, Elsevier, vol. 185(3), pages 998-1010, March.
    19. Arrieta, Alejandro, 2011. "Health reform and cesarean sections in the private sector: The experience of Peru," Health Policy, Elsevier, vol. 99(2), pages 124-130, February.
    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. Jimena Soledad Ferraro & Alan Acosta & Khare Shagun, 2021. "Physician convenience and cesarean section delivery," Asociación Argentina de Economía Política: Working Papers 4469, Asociación Argentina de Economía Política.
    2. Facchini, Gabriel, 2022. "Low staffing in the maternity ward: Keep calm and call the surgeon," Journal of Economic Behavior & Organization, Elsevier, vol. 197(C), pages 370-394.
    3. Surana, Mitul & Dongre, Ambrish, 2018. "Too much care? Private health care sector and surgical interventions during childbirth in India," IIMA Working Papers WP 2018-11-01, Indian Institute of Management Ahmedabad, Research and Publication Department.

    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. Alejandro Arrieta & Ariadna García-Prado, 2012. "Non-elective cesarean sections in public hospitals: hospital capacity constraints and doctor´s incentives," Documentos de Trabajo - Lan Gaiak Departamento de Economía - Universidad Pública de Navarra 1212, Departamento de Economía - Universidad Pública de Navarra.
    2. Aleksandr Proshin & Alexandre Cazenave-Lacroutz & Zeynep Or & Lise Rochaix, 2018. "Impact of Diagnosis Related Group Refinement on the Choice Between Scheduled Caesarean Section and Normal Delivery: Recent Evidence from France," PSE Working Papers halshs-01812107, HAL.
    3. Lo, Joan C., 2008. "Financial incentives do not always work--An example of cesarean sections in Taiwan," Health Policy, Elsevier, vol. 88(1), pages 121-129, October.
    4. Ke-Zong Ma & Edward Norton & Shoou-Yih Lee, 2011. "Mind the information gap: fertility rate and use of cesarean delivery and tocolytic hospitalizations in Taiwan," Health Economics Review, Springer, vol. 1(1), pages 1-15, December.
    5. De Luca, Giacomo & Lisi, Domenico & Martorana, Marco & Siciliani, Luigi, 2021. "Does higher Institutional Quality improve the Appropriateness of Healthcare Provision?," Journal of Public Economics, Elsevier, vol. 194(C).
    6. Jensen, Vibeke Myrup & Wüst, Miriam, 2015. "Can Caesarean section improve child and maternal health? The case of breech babies," Journal of Health Economics, Elsevier, vol. 39(C), pages 289-302.
    7. Jimena Soledad Ferraro & Alan Acosta & Khare Shagun, 2021. "Physician convenience and cesarean section delivery," Asociación Argentina de Economía Política: Working Papers 4469, Asociación Argentina de Economía Política.
    8. Barili, Emilia & Bertoli, Paola & Grembi, Veronica, 2021. "Fee equalization and appropriate health care," Economics & Human Biology, Elsevier, vol. 41(C).
    9. Francese, Maura & Piacenza, Massimiliano & Romanelli, Marzia & Turati, Gilberto, 2014. "Understanding inappropriateness in health spending: The role of regional policies and institutions in caesarean deliveries," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 262-277.
    10. Barili, E; & Bertoli, P; & Grembi, V;, 2020. "Title: Fees equalization and Appropriate Health Care," Health, Econometrics and Data Group (HEDG) Working Papers 20/09, HEDG, c/o Department of Economics, University of York.
    11. Daniele Fabbri & Chiara Monfardini, 2008. "Style of practice and assortative mating: a recursive probit analysis of Caesarean section scheduling in Italy," Applied Economics, Taylor & Francis Journals, vol. 40(11), pages 1411-1423.
    12. Halla, Martin & Mayr, Harald & Pruckner, Gerald J. & García-Gómez, Pilar, 2020. "Cutting fertility? Effects of cesarean deliveries on subsequent fertility and maternal labor supply," Journal of Health Economics, Elsevier, vol. 72(C).
    13. Karen Norberg & Juan Pantano, 2016. "Cesarean sections and subsequent fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 29(1), pages 5-37, January.
    14. Yu, Serena & Fiebig, Denzil G. & Viney, Rosalie & Scarf, Vanessa & Homer, Caroline, 2022. "Private provider incentives in health care: The case of caesarean births," Social Science & Medicine, Elsevier, vol. 294(C).
    15. Carine Milcent & Saad Zbiri, 2022. "Supplementary private health insurance: The impact of physician financial incentives on medical practice," Health Economics, John Wiley & Sons, Ltd., vol. 31(1), pages 57-72, January.
    16. Bachner, Florian & Halla, Martin & Pruckner, Gerald J., 2024. "Do Empty Beds Cause Cesarean Deliveries?," IZA Discussion Papers 16981, Institute of Labor Economics (IZA).
    17. Alex Proshin & Alexandre Cazenave‐Lacroutz & Lise Rochaix, 2023. "Impact of tariff refinement on the choice between scheduled C‐section and normal delivery: Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 32(7), pages 1397-1433, July.
    18. Karen Norberg & Juan Pantano, 2016. "Cesarean sections and subsequent fertility," Journal of Population Economics, Springer;European Society for Population Economics, vol. 29(1), pages 5-37, January.
    19. Gabriel A. Facchini Palma, 2020. "Low Staffing in the Maternity Ward: Keep Calm and Call the Surgeon," Working Papers wpdea2009, Department of Applied Economics at Universitat Autonoma of Barcelona.
    20. Grant, Darren, 2022. "The “Quiet Revolution” and the cesarean section in the United States," Economics & Human Biology, Elsevier, vol. 47(C).

    More about this item

    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:taf:applec:v:48:y:2016:i:49:p:4719-4731. 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: Chris Longhurst (email available below). General contact details of provider: http://www.tandfonline.com/RAEC20 .

    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.