Low-risk isn't no-risk: Perinatal treatments and the health of low-income newborns
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Low-risk isn't no-risk : Perinatal treatments and the health of low-income newborns. / Daysal, N. Meltem; Trandafir, Mircea; van Ewijk, Reyn.
In: Journal of Health Economics, Vol. 64, 03.2019, p. 55-67.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Low-risk isn't no-risk
T2 - Perinatal treatments and the health of low-income newborns
AU - Daysal, N. Meltem
AU - Trandafir, Mircea
AU - van Ewijk, Reyn
PY - 2019/3
Y1 - 2019/3
N2 - We investigate the effects of perinatal medical treatments on low-income newborns who are classified as low-risk. A policy rule in The Netherlands states that low-risk deliveries before week 37 should be supervised by physicians and later deliveries only by midwives with no physician present. This creates large discontinuities in the probability of receiving medical interventions only physicians are allowed to perform. Using a regression discontinuity design, we find that babies born slightly before the week-37 cutoff are significantly less likely to die than babies born slightly later. Our data suggest that physician supervision of birth reduces the likelihood of adverse events such as fetal distress or emergency C-section. Our results indicate that low-income women benefit from receiving a higher level of medical care even if no explicit risk factors have been recognized, pointing to challenges in identifying all high-risk pregnancies. “Back-of-the-envelope” calculations suggest this additional care is highly cost-effective.
AB - We investigate the effects of perinatal medical treatments on low-income newborns who are classified as low-risk. A policy rule in The Netherlands states that low-risk deliveries before week 37 should be supervised by physicians and later deliveries only by midwives with no physician present. This creates large discontinuities in the probability of receiving medical interventions only physicians are allowed to perform. Using a regression discontinuity design, we find that babies born slightly before the week-37 cutoff are significantly less likely to die than babies born slightly later. Our data suggest that physician supervision of birth reduces the likelihood of adverse events such as fetal distress or emergency C-section. Our results indicate that low-income women benefit from receiving a higher level of medical care even if no explicit risk factors have been recognized, pointing to challenges in identifying all high-risk pregnancies. “Back-of-the-envelope” calculations suggest this additional care is highly cost-effective.
KW - Birth
KW - Medical interventions
KW - Medical treatments
KW - Midwives
KW - Mortality
KW - Perinatal care
KW - Prematurity
U2 - 10.1016/j.jhealeco.2019.01.006
DO - 10.1016/j.jhealeco.2019.01.006
M3 - Journal article
C2 - 30797113
AN - SCOPUS:85061713761
VL - 64
SP - 55
EP - 67
JO - Journal of Health Economics
JF - Journal of Health Economics
SN - 0167-6296
ER -
ID: 256519803