The strange case of appropriate C-sections:DRG-tariff regulation, hospital ownership, and market concentration

Berta, P.;, Gianmaria Martini, Massimiliano Piacenza and Gilberto Turati (gilberto.turati@unicatt.it)

Health, Econometrics and Data Group (HEDG) Working Papers from HEDG, c/o Department of Economics, University of York

Abstract: The aim of this paper is to discuss how different types of hospitals respond to large financial incentives for vaginal deliveries and to financial disincentives for C-sections. We focus on a public health care system based on the quasi–market model. We theoretically and empirically evaluate a government policy equalizing the tariff for C-section and vaginal deliveries at a level such that hospitals face monetary disincentives for C-section and monetary incentives for vaginal deliveries. We first theoretically show that hospital ownership matters insofar different types of hospitals are characterized by different ethical preferences; but ownership interacts with market concentration. We then consider the case-study of Lombardy in Italy. We exploit spatial variation in the presence of for-profit, not-for-profit and public hospitals and in the market concentration at the local level to evaluate the relationship between ownership and the probability of C-section. Our empirical results strongly suggest that competitive pressures from alternative providers tend to homogenize behaviors. However, in local monopolies, we do observe less C-section from private for-profit hospitals than from public and private non-profit hospitals especially when they are medically appropriate.

Keywords: public; for-profit and nonprofit hospital; market for birth deliveries; tariff regulation; c-sections (search for similar items in EconPapers)
JEL-codes: D21 D22 I11 I18 L22 L33 (search for similar items in EconPapers)
Date: 2019-01
New Economics Papers: this item is included in nep-eur and nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.york.ac.uk/media/economics/documents/hedg/workingpapers/1902.pdf Main text (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:yor:hectdg:19/02

Access Statistics for this paper

More papers in Health, Econometrics and Data Group (HEDG) Working Papers from HEDG, c/o Department of Economics, University of York HEDG/HERC, Department of Economics and Related Studies, University of York, York, YO10 5DD, United Kingdom. Contact information at EDIRC.
Bibliographic data for series maintained by Jane Rawlings (jane.rawlings@york.ac.uk).