tailieunhanh - Báo cáo toán học: " Mind the information gap: fertility rate and use of cesarean delivery and tocolytic hospitalizations in Taiwan"

Tuyển tập các báo cáo nghiên cứu khoa học ngành toán học được đăng trên tạp chí toán học quốc tế đề tài: Mind the information gap: fertility rate and use of cesarean delivery and tocolytic hospitalizations in Taiwan | Ma et al. Health Economics Review 2011 1 20 http content 1 1 20 o Health Economics Review a SpringerOpen Journal RESEARCH Open Access Mind the information gap fertility rate and use of cesarean delivery and tocolytic hospitalizations in Taiwan Ke-Zong M Ma1 Edward C Norton2 3 and Shoou-Yih D Lee2 Abstract Background Physician-induced demand PID is an important theory to test given the longstanding controversy surrounding it. Empirical health economists have been challenged to find natural experiments to test the theory because PID is tantamount to strong income effects. The data requirements are both a strong exogenous change in income and two types of treatment that are substitutes but have different net revenues. The theory implies that an exogenous fall in income would lead physicians to recoup their income by substituting a more expensive treatment for a less expensive treatment. This study takes advantages of the dramatic decline in the Taiwanese fertility rate to examine whether an exogenous and negative income shock to obstetricians and gynecologists ob gyns affected the use of c-sections which has a higher reimbursement rate than vaginal delivery under Taiwan s National Health Insurance system during the study period and tocolytic hospitalizations. Methods The primary data were obtained from the 1996 to 2004 National Health Insurance Research Database in Taiwan. We hypothesized that a negative income shock to ob gyns would cause them to provide more c-sections and tocolytic hospitalizations to less medically-informed pregnant women. Multinomial probit and probit models were estimated and the marginal effects of the interaction term were conducted to estimate the impacts of ob gyn to birth ratio and the information gap. Results Our results showed that a decline in fertility did not lead ob gyns to supply more c-sections to less medically-informed pregnant women and that during fertility decline ob gyns may supply more tocolytic

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