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

Stefanie Fischer, Heather Royer and Corey White

American Economic Journal: Applied Economics, 2024, vol. 16, issue 3, 113-41

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.

JEL-codes: I11 I18 J13 J16 (search for similar items in EconPapers)
Date: 2024
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DOI: 10.1257/app.20220341

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