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Changing physicians’ incentives to control the C-section rate: Evidence from a major health care reform in Iran

Hanifa Pilvar and Kowsar Yousefi

Journal of Health Economics, 2021, vol. 79, issue C

Abstract: We evaluate the effect of a major health care policy in public hospitals which changed the demand and supply side incentives for c-section procedures in 2014 in Iran, where the c-section rate at the time was 55%. Following the reform, vaginal delivery became free for patients. The policy also introduced financial incentives to doctors for performing vaginal deliveries and set a cap on their maximum c-section rate. We show that supply side incentives had a major role in the effectiveness of the programme, after which the national rate reduced by 6 percentage points. This reduction was mainly driven by first-birth mothers. The reform also shifted doctors with high c-section rates out of public hospitals. We cannot find any adverse effect on Apgar score, hospitalisation or mortality; however, gestation length and birth weight significantly increased.

Keywords: C-section; Health policy; Physicians’ Financial incentives; Birth timing (search for similar items in EconPapers)
JEL-codes: I12 I18 J13 (search for similar items in EconPapers)
Date: 2021
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Citations: View citations in EconPapers (2)

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Persistent link: https://EconPapers.repec.org/RePEc:eee:jhecon:v:79:y:2021:i:c:s0167629621000990

DOI: 10.1016/j.jhealeco.2021.102514

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Journal of Health Economics is currently edited by J. P. Newhouse, A. J. Culyer, R. Frank, K. Claxton and T. McGuire

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