医疗保健集中化：美国产科病区关闭的健康影响
Health Care Centralization: The Health Impacts of Obstetric Unit Closures in the United States
American Economic Journal: Applied Economics · 2024 · [{"name": "Stefanie Fischer", "affiliation": ["Monash University"]}, {"name": "Heather Royer", "affiliation": ["University of California, Santa Barbara"]}, {"name": "Corey White", "affiliation": ["Monash University"]}]
中文摘要
过去几十年间，美国的医疗保健服务在地理分布上日趋集中。我们采用双重差分设计，研究400多个县失去医院产科病区如何影响母婴健康。我们发现，产科病区关闭导致产妇在引产、剖宫产等分娩程序上经历显著变化。与公共讨论中表达的担忧相反，这一变化对一系列母婴健康结果的影响微乎其微，甚至略有裨益。尽管女性为获得护理而出行更远，产科病区关闭仍促使她们获得了更高质量的护理。(JEL I11, I18, J13, J16)
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 I11, I18, J13, J16)