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提供初级医疗保健是否改善出生结局?

Does the Delivery of Primary Healthcare Improve Birth Outcomes?
Journal of Human Resources · 2026 · Esra Kose、Siobhan O’Keefe、Maria Fernanda Rosales-Rueda

中文摘要

社区卫生中心(CHCs)通过在弱势地区设立按收入调整收费的诊所,为医疗服务不足的人群提供初级医疗保健。我们利用社区卫生中心的逐步推行,采用灵活的事件研究框架,结合生命统计出生数据,考察这一政策如何影响婴儿健康。我们发现,在社区卫生中心设立后的七年内,母亲获得其服务改善了婴儿健康结局。处理组平均处理效应估计表明,出生体重增加了25至42克,低出生体重的可能性降低了9%至16%。这些改善可以由早期产前保健可及性的提高以及母亲吸烟的减少来解释。

Abstract

Abstract Community Health Centers (CHCs) deliver primary care to underserved populations by locating sliding-scale clinics in disadvantaged areas. We investigate how this policy affected infant health using the rollout of CHCs and a flexible event study framework with Vital Statistics natality data. We find that maternal access to CHCs improves infant health outcomes within seven years after their introduction. Treatment-on-the-treated estimates show a 25- to 42-gram increase in birth weight and a 9% to 16% reduction in the likelihood of low birth weight. These improvements can be explained by increased access to early prenatal care and reductions in maternal smoking.
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