中文摘要
本研究考察一项自愿性的医院认证项目及其对患者健康结果的影响。爱婴医院行动(Baby-Friendly Hospital Initiative)对坚持多种被认为有助于促进母乳喂养的实践的参与医院授予“爱婴医院”认定。我们估计在爱婴医院出生对母乳喂养启动和婴儿健康的影响。识别依赖于同一母亲内部的分析，比较在同一家医院出生的兄弟姐妹：一个出生于医院尚未获得认证时，另一个出生于医院已获得认证时。数据来自2010年至2019年南卡罗来纳州的出生证明，并与随后的急诊科记录、医院记录和死亡证明相链接。结果表明，爱婴医院认证对母乳喂养启动没有普遍性影响。不过，它确实提高了有奶瓶喂养史的黑人母亲这一子群体中的母乳喂养率。暴露于该认定的婴儿更有可能在不足两天内出院，且也有一定证据表明其后一年内的医疗服务利用有所减少。我们未发现一年期全因死亡率存在精确的变化，尽管我们确实观察到由“极度不成熟”导致的死亡出现边际显著的下降。本文由 Anita Carson(医疗健康管理)接收。补充材料：数据文件可在 https://doi.org/10.1287/mnsc.2024.06422 获取。
Abstract
This study considers a voluntary hospital certification program and how it shapes patient health outcomes. The Baby-Friendly Hospital Initiative designates participating hospitals as “Baby-Friendly” if they adhere to various practices thought to promote breastfeeding. We estimate the effect of being born in a Baby-Friendly hospital on breastfeeding initiation and infant health. Identification relies on a within-mother analysis that compares siblings who were born in the same hospital: one when the hospital was not certified and another when the hospital was certified. Data come from South Carolina birth certificates from 2010 to 2019 linked to subsequent emergency department records, hospital records, and death certificates. The results indicate that Baby-Friendly accreditation has no widespread effects on breastfeeding initiation. It does, however, increase breastfeeding rates among a subset of Black mothers with a history of bottle-feeding. Infants exposed to the designation are more likely to leave the hospital in under two days, and there is also some evidence of subsequent reductions in healthcare utilization in the next year. We do not find precise changes in all-cause one-year mortality, although we do observe a marginally significant reduction in deaths caused by “extreme immaturity.” This paper was accepted by Anita Carson, healthcare management. Supplemental Material: The data files are available at https://doi.org/10.1287/mnsc.2024.06422 .