Incentivizing Demand for Supply-Constrained Care: Institutional Birth in India

• 成果类型: Article
• 署名作者: Andrew, Alison; Vera-Hernandez, Marcos
• 署名单位: University of Oxford; University of London; London School Economics & Political Science
• 刊物名称: REVIEW OF ECONOMICS AND STATISTICS
• ISSN/ISSBN: 0034-6535
• DOI: 10.1162/rest_a_01206
• 发表日期: 2024-01
• 页码: 102-118
• 关键词: health-care; mortality; QUALITY

摘要

If overcrowding harms health care quality, the impacts of encouraging more people to use services are not obvious. Impacts will depend on whether marginal entrants benefit and whether they benefit enough to offset the congestion externalities imposed on inframarginal users. We develop a general-equilibrium model that formalizes these ideas. We examine them empirically by studying JSY, a program in India that paid women to give birth in medical facilities. We find evidence that JSY increased perinatal mortality in areas with low health-system capacity, was particularly harmful in more-complex births, reduced the quality of facilities' postnatal care, and generated harmful spillovers onto other services.